{"id":"fc27ebb2-dfbf-4572-93e0-23bff22cd105","slug":"herniation-of-the-cauda-equina-into-the-facet-joint-through-a-pseudomeningocele-a-case-report-and-literature-review","title":"Herniation of the cauda equina into the facet joint through a pseudomeningocele: A case report and literature review","authors":["Jumpei Iida","Naohisa Miyakoshi","Michio Hongo","Hiroshi Sasaki","Hiroki Ito","Hitoshi Kubota","Takeshi Sato","Yoichi Shimada"],"abstract":"Background: Incidental durotomy is a well-known complication of spinal surgery. It can lead to persistent cerebrospinal fluid leakage resulting in significant secondary complications. Here, we present a case in which the cauda equina herniated into a pseudomeningocele that penetrated a facet joint, leading to lower extremity radiculopathy warranting surgical correction. Case Description: One year ago, a 67-year-old male underwent a partial left L4-L5 laminectomy. At surgery, a durotomy was repaired with a nylon suture and reinforced with a fat patch. He subsequently presented with severe left lower extremity radiculopathy and a partial cauda equina syndrome. On MR, the cauda equina had herniated into a pseudomeningocele that penetrated the left facet joint. Once the defect was repaired at surgery, the patient’s symptoms improved. Conclusion: It is critical to correctly repair an intraoperative durotomy to avoid further neurological deficits that may include cauda equina herniation into pseudomeningoceles penetrating facet joints.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/fc27ebb2-dfbf-4572-93e0-23bff22cd105/featured/hero-1781562785658.png","publishDate":"2021-01-20T00:00:00.000Z","doi":"10.25259/SNI_893_2020","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2021/01/10529/SNI-12-30.pdf"}