Rare Complications of Cervical Spine Surgery: Pseudomeningocoele.

Authors

Tamir Ailon, University of British Columbia
Justin S. Smith, University of VirginiaFollow
Ahmad Nassr, Mayo Clinic
Zachary A. Smith, Northwestern UniversityFollow
Wellington K. Hsu, Northwestern UniversityFollow
Michael G. Fehlings, Toronto Western HospitalFollow
David E. Fish, UCLA Spine CenterFollow
Jeffrey C. Wang, USC Spine CenterFollow
Alan S. Hilibrand, Thomas Jefferson UniversityFollow
Praveen V. Mummaneni, University of California San FranciscoFollow
Dean Chou, University of California San FranciscoFollow
Rick C. Sasso, Indiana University, IndianapolisFollow
Vincent C. Traynelis, Rush University Medical Center
Paul M. Arnold, Kansas University Medical CenterFollow
Thomas E. Mroz, Cleveland Clinic
Zorica Buser, University of Southern California
Elizabeth L L. Lord, UCLA Spine CenterFollow
Eric M. Massicotte, University of TorontoFollow
Arjun S. Sebastian, Mayo Clinic
Khoi D. Than, Oregon Health and Science University
Michael P. Steinmetz, Cleveland Clinic FoundationFollow
Gabriel A. Smith, University Hospitals Case Medical CenterFollow
Jonathan Pace, University Hospitals Case Medical Center
Mark Corriveau, University of Wisconsin Hospital and ClinicsFollow
Sungho Lee, University Hospitals Case Medical CenterFollow
K. Daniel Riew, Columbia University; New York-Presbyterian/The Allen HospitalFollow
Christopher Shaffrey, University of VirginiaFollow

Document Type

Article

Publication Date

4-1-2017

Comments

This article has been peer reviewed. It is the author’s final published version in Global Spine Journal

Volume 7, Issue 1, April 2017, Pages 109S-114S.

The published version is available at DOI: 10.1177/2192568216687769. Copyright © Ailon et al.

Abstract

STUDY DESIGN: This study was a retrospective, multicenter cohort study.

OBJECTIVES: Rare complications of cervical spine surgery are inherently difficult to investigate. Pseudomeningocoele (PMC), an abnormal collection of cerebrospinal fluid that communicates with the subarachnoid space, is one such complication. In order to evaluate and better understand the incidence, presentation, treatment, and outcome of PMC following cervical spine surgery, we conducted a multicenter study to pool our collective experience.

METHODS: This study was a retrospective, multicenter cohort study of patients who underwent cervical spine surgery at any level(s) from C2 to C7, inclusive; were over 18 years of age; and experienced a postoperative PMC.

RESULTS: Thirteen patients (0.08%) developed a postoperative PMC, 6 (46.2%) of whom were female. They had an average age of 48.2 years and stayed in hospital a mean of 11.2 days. Three patients were current smokers, 3 previous smokers, 5 had never smoked, and 2 had unknown smoking status. The majority, 10 (76.9%), were associated with posterior surgery, whereas 3 (23.1%) occurred after an anterior procedure. Myelopathy was the most common indication for operations that were complicated by PMC (46%). Seven patients (53%) required a surgical procedure to address the PMC, whereas the remaining 6 were treated conservatively. All PMCs ultimately resolved or were successfully treated with no residual effects.

CONCLUSIONS: PMC is a rare complication of cervical surgery with an incidence of less than 0.1%. They prolong hospital stay. PMCs occurred more frequently in association with posterior approaches. Approximately half of PMCs required surgery and all ultimately resolved without residual neurologic or other long-term effects.

Recommended Citation

Ailon, Tamir; Smith, Justin S.; Nassr, Ahmad; Smith, Zachary A.; Hsu, Wellington K.; Fehlings, Michael G.; Fish, David E.; Wang, Jeffrey C.; Hilibrand, Alan S.; Mummaneni, Praveen V.; Chou, Dean; Sasso, Rick C.; Traynelis, Vincent C.; Arnold, Paul M.; Mroz, Thomas E.; Buser, Zorica; Lord, Elizabeth L L.; Massicotte, Eric M.; Sebastian, Arjun S.; Than, Khoi D.; Steinmetz, Michael P.; Smith, Gabriel A.; Pace, Jonathan; Corriveau, Mark; Lee, Sungho; Riew, K. Daniel; and Shaffrey, Christopher, "Rare Complications of Cervical Spine Surgery: Pseudomeningocoele." (2017). Rothman Institute Faculty Papers. Paper 84.
https://jdc.jefferson.edu/rothman_institute/84

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