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Traumatic Fracture of Thin Pedicles Secondary to Extradural Meningeal Cyst


DS Yanni
A Mammis
NG Thaker
IM Goldstein

Abstract

Spinal dural meningoceles and diverticula are meningeal
cysts that have a myriad of clinical presentations and sequelae, secondary to local mass effect. Our objective is to report a technical case report, illustrating a traumatic spinal injury with multiple pedicle fractures, secondary to atrophic lumbar pedicles as well as the diagnostic workup and surgical management of this problem. Posterior lumbar decompression, resection of the meningeal cyst, ligation of the cyst ostium, instrumentation, and fusion were performed with the assistance of intraoperative isocentric fluoroscopy. The cyst’s point of communication was successfully located with intraoperative fluoroscopy and the lesion was successfully excised. We suggest that patients with
traumatic spinal injuries, having evidence of pre-existing
anomalous bony architecture, undergo advanced imaging
studies, to rule out intraspinal pathology. The positive clinical and radiographic results support the removal and closure of the pre-existing meningeal cyst at the time of treatment of traumatic spinal injury. Intraoperative isocentric fluoroscopy is a helpful tool in the operative management of these lesions.

Journal Identifiers


eISSN: 2006-8808
print ISSN: 2006-8808