Study design: A case report of spontaneous resolution of a lumbar postdiscectomy pseudomeningocoele.
Objectives: To suggest the role of nonoperative treatment even in symptomatic pseudomeningocoeles.
Setting: Withybush General Hospital, Haverfordwest, Pembrokeshire, South Wales, UK.
Case report: A 65-year-old lady underwent L4/L5 discectomy for lumbar disc prolapse in 1998. As the patient did not have relief of symptoms, an MRI was taken at 1 month following the operation, which showed a residual disc at L4/L5 and a pseudomeningocoele communicating with the subarachnoid space. The patient could not undergo further treatment because of the untimely demise of the surgeon. Over the next 3 months, the symptoms began to improve and the patient was totally asymptomatic and remained so for 3 years. In 2001, she was seen for a recurring leg pain and back pain and an MRI was done, which showed complete disappearance of the pseudomeningocoele but with recurrent disc lesion.
Conclusion: Although the current medical literature favours re-exploration and repair of the dural defect in symptomatic pseudomeningocoele, the authors are of the opinion that conservative treatment may have a role in the treatment of the above condition as illustrated by the above example.