Skip to main content
SpringerLink
Log in

Repair of giant lumbosacral pseudomeningocele with fast-resorbing polymer mesh in a pediatric patient operated for posterior dysraphism

  • Technical Note
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Lumbar pseudomeningocele is a common complication of spinal surgery. It is caused by dural defect, and it consists of extradural collection of cerebrospinal fluid communicating with subarachnoid space. Usually it is small, asymptomatic, and self-limiting. In case of persistence, common treatments include bedrest, puncture and compressive dressing, subcutaneous or subarachnoid lumbar drainage, surgical re-exploration for durotomy closure, and blood patch. Fast-resorbing polymer mesh has been recently used for closure osseous gap in adult patients who developed giant pseudomeningocele following laminectomy. We report the case of a 16-year-old girl, affected by spinal dysraphism, who developed a persistent giant lumbar pseudomeningocele after repeated surgery for detethering of the spinal cord and removing of spinal lipomyelomeningocele. She was finally treated with fast-resorbing polymer mesh, to fill the gap of the posterior osseous defect and to provide support for the thecal sac. For our best knowledge, this is the first pediatric case reported in literature on this kind of reconstruction. In complex cases of pseudomeningocele, implant of fast-resorbing polymer mesh may represent an option also in pediatric patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Alvarez CM, Urakov TM, Vanni S (2018) Repair of giant postlaminectomy pseudomeningocele with fast-resorbing polymer mesh: technical report of 2 cases. J Neurosurg Spine 28:341–344

    Article  PubMed  Google Scholar 

  2. Chen YN, Yang SH, Chou SC, Kuo MF (2019) The role of sacral laminoplasty in the management of spina bifida and sacral cystic lesions: case series. Neurosurg Focus 47(4):E20. https://doi.org/10.3171/2019.7.FOCUS19414

    Article  PubMed  Google Scholar 

  3. Cohen SR, Mittermiller PA, Holmes RE, Broder KW (2006) Clinical experience with a new fast-resorbing polymer for bone stabilization in craniofacial surgery. J Craniofac Surg 17:40–43

    Article  PubMed  Google Scholar 

  4. Hida K, Yamaguchi S, Seki T, Yano S, Akino M, Terasaka S, Uchida T, Iwasaki Y (2006) Nonsuture dural repair using polyglycolic acid mesh and fibrin glue: clinical application to spinal surgery. Surg Neurol 65:136–143 discussion 142–3

    Article  PubMed  Google Scholar 

  5. Masuda S, Fujibayashi S, Otsuki B, Kimura H, Neo M, Matsuda S (2016) The dural repair using the combination of polyglycolic acid mesh and fibrin glue and postoperative management in spine surgery. J Orthop Sci 21(5):586–590. https://doi.org/10.1016/j.jos.2016.07.016

    Article  PubMed  Google Scholar 

  6. Misra SN, Morgan HW, Sedler R (2003) Lumbar myofascial flap for pseudomeningocele repair. Neurosurg Focus 15:E13

    PubMed  Google Scholar 

  7. Solomon P, Sekharappa V, Krishnan V, David KS (2013) Spontaneous resolution of postoperative lumbar pseudomeningoceles: a report of four cases. Indian J Orthop 47:417–421

    PubMed  PubMed Central  Google Scholar 

  8. Terasaka S, Hida K, Iwasaki Y (2003) Experimental and clinical evaluation for the use of the bioabsorbable dural substitute. Sekitsui Sekizui J (Spine Spinal Cord) 9(1):23e7

    Google Scholar 

  9. Varma Kalidindi KK, Bhat MR, Mannem A, Chhabra HS (2019) Conservative management for late-presenting dural tears after spine surgery: an institutional experience and literature review. World Neurosurg 134:e82–e92. https://doi.org/10.1016/j.wneu.2019.09.067

    Article  Google Scholar 

  10. Weng YJ, Cheng CC, Li YY, Huang TJ, Hsu RW (2010) Management of giant pseudomeningoceles after spinal surgery. BMC Musculoskelet Disord 11:53

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosciences, Department of Pediatric Neurosurgery, Santobono-Pausilipon Children’s Hospital, Via Mario Fiore 6, 80121, Naples, Italy

    Claudio Ruggiero, Marcello Barbato, Pietro Spennato & Giuseppe Cinalli

  2. Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University Federico II, Naples, Italy

    Marcello Barbato

  3. Department of Neurosciences, Department of Neuroradiology, Santobono-Pausilipon Children’s Hospital, Naples, Italy

    Carmela Russo & Domenico Cicala

Authors
  1. Claudio Ruggiero
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marcello Barbato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pietro Spennato
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carmela Russo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Domenico Cicala
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giuseppe Cinalli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pietro Spennato.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the 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 standard.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ruggiero, C., Barbato, M., Spennato, P. et al. Repair of giant lumbosacral pseudomeningocele with fast-resorbing polymer mesh in a pediatric patient operated for posterior dysraphism. Childs Nerv Syst 36, 1777–1780 (2020). https://doi.org/10.1007/s00381-020-04613-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-020-04613-7

Keywords

Search

Navigation