[Postoperative spinal cord herniation diagnosed by metrizamide CT: a case report]

Area of Science:

• Neurosurgery
• Radiology

Background:

• Post-laminectomy complications can include spinal cord issues.
• Iatrogenic spinal cord herniation is a rare but serious sequela.

Observation:

• A 55-year-old man presented with progressive gait disturbance 13 years post-C4-7 laminectomy.
• Neurological exam revealed spastic gait, hyperreflexia, and sensory deficits.
• Metrizamide CT demonstrated pseudomeningocele and cervical cord herniation at C6-7 with a narrow C3 canal.

Findings:

• Intraoperative findings confirmed posterior cervical cord herniation through a dural defect at C6-7.
• Pseudomeningocele was also identified, originating from a C5 level leak.
• The case highlights iatrogenic spinal cord herniation as a delayed complication.

Implications:

• Metrizamide CT is valuable for diagnosing postoperative spinal cord herniation.
• Early diagnosis and surgical intervention are critical for managing spinal cord compression.
• Understanding rare complications like iatrogenic herniation improves surgical outcomes.