Surgical Management of Idiopathic Thoracic Spinal Cord Herniation.


Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: [Email]


BACKGROUND : Idiopathic spinal cord herniation is a rare condition that involves spinal cord herniation through a defect in the ventral dura.
METHODS : We present a case of a 61-year-old woman who initially presented in 2016 with an approximately 1-year history of burning right lower extremity pain and gait instability. Her neurologic examination was consistent with thoracic Brown-Sequard syndrome, and spinal magnetic resonance imaging showed a focal defect in the ventral dura at the superior aspect of T4 with the left aspect of the cord herniating into the defect. In 2018, she underwent a T3-T4 laminectomy with T3 pedicle take down and medial facetectomy, with reduction of the herniated cord.
CONCLUSIONS : Idiopathic spinal cord herniation is an uncommon spinal cord disorder with a paucity of data reported. Our case report of a classic case of idiopathic spinal cord herniation presenting as Brown-Sequard syndrome and managed surgically will contribute to the data in this field.


Brown−Sequard,Cord herniation,Operative video,Surgery,Thoracic spine,

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