Therapeutic intervention for iatrogenic thoracolumbar pseudomeningocele using ultrasound-guided aspiration and ultrasound-assisted epidural blood patch - A case report.

Cerebrospinal fluid (CSF) leakage causing a pseudomeningocele is a well-recognized complication after spine surgery. It presents as a recurrence of low-back pain, radiculopathy, subcutaneous swelling, symptoms of intracranial hypotension, and delayed myelopathy. Definitive surgical repair is needed if not resolved spontaneously or with minimally invasive measures like lumbar subarachnoid drainage and an epidural blood patch (EBP). We report a case of iatrogenic thoracic pseudomeningocele, successfully treated with dual therapeutic intervention (CSF aspiration and EBP) using an ultrasound. This minimally-invasive intervention helped our patient resolve symptoms, avoid radiation, and make it cost-effective by avoiding surgical intervention and polypharmacy of general anesthesia.