Retroperitoneal pseudomeningocele complicated by meningitis following a lumbar burst fracture. A case report.
METHODS
This case report demonstrates an unusual complication after anterior decompression and fusion of a lumbar burst fracture.


OBJECTIVE
The treatment of this patient involved placement of a computed tomography-guided percutaneous drain and intravenous antibiotics to treat an infected retroperitoneal pseudomeningocele.


BACKGROUND
A case of an anterior retroperitoneal pseudomeningocele complicated by meningitis is presented. This pseudomeningocele occurred in a patient after an L3 burst fracture associated with a dural laceration.


METHODS
The patient was admitted to the authors' trauma unit after a motor vehicle accident with an acute L3 fracture associated with incomplete paraplegia. He underwent an urgent anterior corpectomy, strut grafting, and instrumentation. At surgery, he was noted to have a large anterior dural laceration. After surgery, a large retroperitoneal pseudomeningocele developed that became infected with Staphylococcus epidermidis.


RESULTS
After placement of a computed tomography-guided percutaneous drain and intravenous antibiotics, the pseudomeningocele resolved. His anterior fusion healed uneventfully and his neurologic deficit improved dramatically.


CONCLUSIONS
A case of an anterior retroperitoneal pseudomeningocele complicated by meningitis is presented. This pseudomeningocele occurred in a patient after an L3 burst fracture associated with a dural laceration. The patient was treated successfully with computed tomography-guided percutaneous drain placement and intravenous antibiotics. He made an excellent functional recovery after a severe neurologic injury.
Nairus
J G
JG
University of Cincinnati College of Medicine, Ohio, USA.
Richman
J D
JD
Douglas
R A
RA
D000293:Adolescent; D004322:Drainage / Q000379:methods; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008581:Meningitis / Q000209:etiology* / Q000628:therapy; D008588:Meningocele / Q000209:etiology* / Q000628:therapy; D012187:Retroperitoneal Space; D012293:Rifampin / Q000627:therapeutic use; D016103:Spinal Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D013203:Staphylococcal Infections / Q000209:etiology* / Q000628:therapy; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D014057:Tomography, X-Ray Computed; D014640:Vancomycin / Q000627:therapeutic use
D014640:Vancomycin; D012293:Rifampin