Symptomatic thoracic spinal cord herniation: case series and technical report
Ammar H Hawasli1, Wilson Z Ray, Neill M Wright
1Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri.
Neurosurgery
|May 30, 2014
Summary
Idiopathic spinal cord herniation (ISCH) presents atypically, often after trauma. Surgical repair offers rapid improvement for symptomatic ISCH, even after prolonged symptoms.
Area of Science:
- Neurosurgery
- Neurology
- Spinal Cord Imaging
Background:
- Idiopathic spinal cord herniation (ISCH) is rare, typically affecting the thoracic spine, often following trauma.
- The presentation, cause, and optimal treatment for ISCH remain incompletely understood.
- Limited data exist regarding clinical outcomes following ISCH management.
Purpose of the Study:
- To describe the atypical presentation, radiographic progression, and treatment outcomes of symptomatic ISCH.
- To present a surgical technique for ISCH repair.
- To compare ISCH outcomes with classic compressive myelopathy.
Main Methods:
- Case series and technical report of 5 patients with symptomatic ISCH.
- Detailed description of atypical myelopathy presentation and surgical repair.
- Serial spinal imaging to assess radiographic progression.
Main Results:
- Symptomatic ISCH patients exhibited atypical myelopathy with asymmetric deficits and early incontinence.
- Clinical deterioration correlated with progressive spinal cord herniation on imaging.
- Surgical treatment resulted in rapid improvement despite long-standing symptoms.
Conclusions:
- Symptomatic ISCH presents with atypical myelopathy and slow progression.
- Surgical repair is a successful management strategy for ISCH.
- Early surgical intervention may optimize outcomes for spinal cord herniation.
