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Pseudomeningocele—a rare complication following thoracic spinal decompression surgery: clinical features, treatment guidelines, technical notes, and evaluation of results

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Abstract

Purpose

Pseudomeningocele (PMC) is a rare complication following thoracic spinal decompression surgery. The aim of this study is to assess the clinical features and treatment of PMC and provide the technical notes with revision surgery.

Methods

Between January 2010 and December 2019, patients who developed PMC after posterior thoracic surgery were enrolled. An additional 25 patients who suffered cerebrospinal fluid leakage (CSFL) but did not develop PMC in the same period were randomly selected. General data, intra-operative factors, CSFL position, cost, modified Japanese Orthopaedic Association (mJOA) scores, patient satisfaction, and clinical features were recorded and compared between the two groups.

Results

Eighteen patients were diagnosed with PMC after thoracic spinal surgery. The average length, width, and depth were 16.25 ± 5.73 cm, 6.96 ± 3.61 cm and 4.39 ± 2.2 cm, respectively. The most common symptom was neurological deficits following incision problems and headache. Compared with the control group, the PMC group showed a longer duration of initial surgery, greater estimated blood loss, an increased rate of CSFL on the ventral side, reduced mJOA scores, and lower patient satisfaction at the final follow-up.

Conclusion

PMC is a rare complication of thoracic surgery with an incidence of 1.12%. PMC typically occurs at the upper and lower thoracic spine, resulting in increased health care costs, poorer neurological recovery, and a lower rate of patient satisfaction. The management of PMC should be individualized depending on diagnosis time and symptoms.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Funding from governmental agencies was received in support of this study. This work was also supported by the fellowship of China Postdoctoral Science Foundation (No. 2020M670002ZX).

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China

    Longjie Wang, Xiaoxi Yang, Hui Wang, Zhongqiang Chen, Chuiguo Sun & Weishi Li

  2. Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China

    Longjie Wang, Xiaoxi Yang, Hui Wang, Zhongqiang Chen, Chuiguo Sun & Weishi Li

  3. Beijing Key Laboratory of Spinal Disease Research, Beijing, China

    Longjie Wang, Xiaoxi Yang, Hui Wang, Zhongqiang Chen, Chuiguo Sun & Weishi Li

Authors
  1. Longjie Wang
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  2. Xiaoxi Yang
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  3. Hui Wang
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  4. Zhongqiang Chen
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  5. Chuiguo Sun
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  6. Weishi Li
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Contributions

Weishi Li contributed to the study conception and design. Data collection and analysis were performed by Longjie Wang, Xiaoxi Yang, and Hui Wang. The figures were designed and drawn by Xiaoxi Yang. The surgeries were performed by the Weishi Li, Zhongqiang Chen, and Chuiguo Sun. The article was written by Longjie Wang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Weishi Li.

Ethics declarations

Ethics approval

This study was approved by Peking University Third Hospital’s ethics committee. For this type of study, formal consent is not required. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

Longjie Wang has received funding from the fellowship of China Postdoctoral Science Foundation (No.2020M670002ZX).

Xiaoxi Yang, Hui Wang, Zhongqiang Chen, Chuiguo Sun, and Weishi Li declare they have no financial interests.

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Wang, L., Yang, X., Wang, H. et al. Pseudomeningocele—a rare complication following thoracic spinal decompression surgery: clinical features, treatment guidelines, technical notes, and evaluation of results. International Orthopaedics (SICOT) 45, 2609–2618 (2021). https://doi.org/10.1007/s00264-021-05156-5

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  • DOI: https://doi.org/10.1007/s00264-021-05156-5

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