Retroperitoneal pseudomeningocele complicated by meningitis following a lumbar burst fracture. A case report.

STUDY

DESIGN

This case report demonstrates an unusual complication after anterior decompression and fusion of a lumbar burst fracture.

OBJECTIVES

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

SUMMARY OF BACKGROUND DATA: 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.