Meenakshi Mission Hospital Removes Large Spinal Fluid-Filled Sac and Corrects Rare Failed Spine Surgery
Madurai : Doctors at Meenakshi Hospital and Research Centre removed a large pseudomeningocele – an abnormal sac filled with cerebrospinal fluid (CSF), a clear, colourless fluid that surrounds and protects the brain and spinal cord – from the lower back of a 60-year-old woman, which had been causing severe back pain. The condition was likely a complication of a previous spine surgery (L5–S1 discectomy) performed elsewhere five years ago.
Since the patient also had advanced disc degeneration in the lower spine (L4–L5 and L5–S1), the team additionally stabilised the spine by fusing the affected vertebrae. The treatment also involved duraplasty, a procedure to repair a tear in the spinal covering and prevent future leakage of spinal fluid. In addition, surgeons performed a special procedure (Limberg flap), repositioning nearby healthy skin and tissue to effectively cover and heal the area, as the long-standing swelling had created a large defect in the back.
After two weeks of hospital stay, the patient’s symptoms had completely resolved. By three months, she had returned to normal daily activities, marking a successful recovery.
In his comments, Dr. R.Vetri Nallathambi,Spine surgeon, Department of Orthopaedics& Traumatology, said, “The patient presented with a swelling in the back, severe back pain radiating to both lower limbs, and giddiness on lying down, which significantly affected daily activities and sleep. MRI revealed a symptomatic pseudomeningocele and L4–L5, L5–S1 disc degeneration. This is a rare and challenging condition requiring complex revision surgery. We successfully removed the fluid-filled sac, repaired the spinal covering, and addressed the underlying long-standing disc pathology, thereby correcting the failed previous surgery and relieving the patient’s symptoms.”
Dr.P. Suresh Kumar, Plastic Surgeon, said, “After the orthopaedic spine team addressed the underlying pathology by excising the pseudomeningocele sac, we were called in to manage the resultant soft tissue deficit. Due to the chronic nature of the condition, a large void had formed in the back, leading to a significant skin and tissue defect. We performed a reconstructive flap procedure to provide stable, healthy skin cover and ensure proper healing of the area.”
Doctors said that failed spine surgeries can often be corrected with appropriate revision procedures, and cautioned that any increasing swelling at the wound site should not be neglected, as it may indicate an underlying complication requiring timely evaluation and treatment.
Dr.V.Sathya Narayana, HOD & Senior Consultant, Department of Orthopaedics & Traumatology , Dr.U.T.Vassan, Senior Consultant, Department of Orthopaedics & Traumatology and Dr. B. Kannan, Medical Administrator, were also present during this press meet.
