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[Spontaneous spinal cord herniation]
J J Rivas1, A de la Lama, P Gonza Lez
1Servicio de Neurocirugía, Hospital 12 de Octubre, Madrid, Spain.
Neurocirugia (Asturias, Spain)
|November 24, 2004
Summary
Spontaneous spinal cord herniation is a rare cause of progressive myelopathy. Surgical repair can halt deficits and improve function, highlighting the need for early diagnosis.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Spontaneous spinal cord herniation through a dural defect is an uncommon condition, potentially underdiagnosed before advanced imaging.
- Progressive myelopathy necessitates consideration of rare etiologies beyond typical spinal cord compression.
Observation:
- A 49-year-old male presented with progressive Brown-Sequard syndrome.
- Magnetic resonance imaging (MRI) and CT myelogram revealed ventral spinal cord displacement at T6-T7 and posterior subarachnoid space expansion.
Findings:
- Surgical exploration identified and reduced a spinal cord herniation through an anterior dural defect.
- The dural defect was repaired using a lyophilized dura patch.
- Post-operatively, the patient regained muscle power but sensory deficits persisted.
Implications:
- Spontaneous spinal cord herniation should be considered in middle-aged patients with progressive myelopathy lacking typical compression signs.
- Early diagnosis and surgical intervention are crucial for managing spinal cord herniation and potentially improving neurological outcomes.