Endoscopically Assisted Release Surgery for Idiopathic Spinal Cord Herniation: Technical Case Instruction
Takashi Yagi1, Toru Tateoka, Hideyuki Yoshioka
1Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo , Yamanashi , Japan.
Operative Neurosurgery (Hagerstown, Md.)
|April 28, 2025
Summary
This study presents an endoscopic technique to treat rare ventral dural defects causing spinal cord herniation. This minimally invasive approach effectively untethers the spinal cord, preventing further neurological damage.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Minimally Invasive Techniques
Background:
- Idiopathic spinal cord herniation through ventral dural defects is a rare condition.
- It typically leads to progressive myelopathy, necessitating surgical intervention.
- Optimal surgical techniques to minimize spinal cord manipulation remain under investigation.
Purpose of the Study:
- To describe endoscopic-assisted surgical techniques for releasing thoracic spinal cord herniation.
- To evaluate the efficacy of minimizing intraoperative spinal cord manipulation.
Main Methods:
- A 60-year-old female patient with Brown-Séquard syndrome underwent hemilaminectomies and pediculectomy.
- Endoscopic guidance was used to dissect adhesions on the left side of the ventral dural defect.
- The spinal cord was untethered, and the dural defect was repaired with a collagen matrix.
Main Results:
- Magnetic resonance imaging confirmed ventral spinal cord displacement at T3-4.
- The spinal cord was found incarcerated in a ventral dural defect.
- Post-operatively, the patient experienced full motor recovery and independent ambulation.
Conclusions:
- Endoscopic assistance is beneficial for thoracic spinal cord herniation release.
- This technique minimizes intraoperative spinal cord manipulation.
- Successful surgical untethering led to significant neurological recovery.
