Hydrocephalus as a Complication of Durotomy during Cervical Laminoplasty - A Case Report -

Jemin Yi

doi:10.4184/jkss.2018.25.2.69

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Yi: Hydrocephalus as a Complication of Durotomy during Cervical Laminoplasty - A Case Report -

Case Report

Journal of Korean Spine Surg 2018;25(2):69-73.

Published online: 30 June 2018

DOI: https://doi.org/10.4184/jkss.2018.25.2.69

Hydrocephalus as a Complication of Durotomy during Cervical Laminoplasty - A Case Report -

Jemin Yi, M.D.

Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea

Corresponding author: Jemin Yi, M,D. ORCID ID: https://orcid.org/0000-0002-4688-5647 Department of Orthopaedic Surgery Dankook University Hospital 201 Manghyang-ro, Dongnam-gu, Cheonan 31116, Korea TEL: +82-41-550-3950, FAX: +82-41-556-0551 E-mail: firekimdo@gmail.com

Received 7 May 201816 May 2018 Accepted 7 June 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Case report.

Objectives

We report a case of hydrocephalus as a complication of durotomy during cervical laminoplasty.

Summary of Literature Review

Hydrocephalus is a very rare complication of cervical laminoplasty.

Materials and Methods

A 72-year-old man had an incidental durotomy during cervical laminoplasty. The dural leak was repaired by secondary surgery. However, the patient continued to complain of headaches and developed confusion and drowsiness. A computed tomographic scan of the brain showed hydrocephalus. After insertion of a lumbar drain, the patient experienced a temporary improvement in the neurologic symptoms. After 6 months, the neurologic symptoms recurred and a ventriculoperitoneal (VP) shunt was placed.

Results

After placement of the VP shunt, the neurologic symptoms improved significantly.

Conclusions

If a patient shows deterioration of neurologic symptoms after an incidental durotomy, surgeons should consider the possibility of hydrocephalus.

Keywords: Hydrocephalus, Durotomy, Cervical laminoplasty

REFERENCES

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Fig. 1.

Preoperative computed tomographic (CT) scan of the cervical spine. (A) A sagittal CT scan shows segmental ossification of the posterior longitudinal ligament (OPLL, arrowheads) spanning from C4 to C5. (B) An axial CT scan at C4 shows encroachment of the spinal canal by the OPLL mass (arrow).

Fig. 2.

Preoperative T2-weighted magnetic resonance imaging (MRI) scan of the cervical spine. (A) A sagittal MRI scan shows increased cord signal intensity (arrow) at C4-C5. (B) An axial MRI scan shows central canal stenosis at C4-C5.

Fig. 3.

T2-weighted sagittal magnetic resonance imaging shows adequate decompression and subcutaneous fluid collection.

Fig. 4.

Computed tomography shows lateral ventricular dilation.

Fig. 5.

Computed tomography 30 days after ventriculoperitoneal shunt placement shows normal ventricular morphology.

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