Unilateral Biportal Endoscopic Decompression-Induced Rare Epidural Pseudocyst: A Rare Case Report

Year 2025, Volume: 14 Issue: 2, 91 - 97, 29.08.2025

Bertan Cem Yavaşoğlu , Mehmet Akif Çaçan , Şahin Karalar , Bekir Yavuz Uçar

https://doi.org/10.47493/abantmedj.1548207

Abstract

Unilateral Biportal Endoscopy (UBE) represents a novel, minimally invasive surgical approach in the management of lumbar spinal stenosis (LSS). It offers distinct advantages over conventional open surgery, including reduced tissue trauma, postoperative pain, and recovery time. However, despite its benefits, UBE is associated with rare complications such as dural tears, nerve root injuries, and pseudocyst formation.
We report the case of a 73-year-old female who presented with severe radicular pain and reduced muscle strength in the left lower extremity following UBE for lumbar stenosis. Postoperatively, the patient experienced recurrent radicular pain. Magnetic resonance imaging (MRI) revealed the presence of a pseudocyst in the left lateral recess. Serum biomarkers showed no evidence of infection. Surgical exploration identified a cystic lesion containing air and serous fluid. The patient underwent open surgical laminectomy and pseudocyst drainage. Histopathological analysis of the lesion confirmed the presence of fibrinous connective tissue.
Although pseudocyst formation is an infrequent complication of UBE, it can lead to significant postoperative morbidity. Management involves surgical intervention and detailed postoperative monitoring. Both UBE and open surgical techniques can be adopted considering its unique advantages in addressing certain postoperative complications. In this case, open surgery was selected to ensure adequate visualization and access to the lesion. Even though a more invasive approach was chosen following the intervention, the patient demonstrated marked clinical improvement post operative day 1, with resolution of the cystic lesion and associated symptoms.
This case underscores the importance of considering pseudocyst formation in the differential diagnosis of postoperative complications following UBE. Prompt recognition and timely surgical management are essential to achieving favorable patient outcomes.

Keywords

complication , spine , pseudocyst , decompression , endoscopic

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