Format

Send to:

Choose Destination
See comment in PubMed Commons below
Neurosurgery. 2014 Sep;10 Suppl 3:E498-504; discussion E504. doi: 10.1227/NEU.0000000000000437.

Symptomatic thoracic spinal cord herniation: case series and technical report.

Author information

  • 1Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri.

Abstract

BACKGROUND AND IMPORTANCE:

Idiopathic spinal cord herniation (ISCH) is an uncommon condition located predominantly in the thoracic spine and often associated with a remote history of a major traumatic injury. ISCH has an incompletely described presentation and unknown etiology. There is no consensus on the treatment algorithm and surgical technique, and there are few data on clinical outcomes.

CLINICAL PRESENTATION:

In this case series and technical report, we describe the atypical myelopathy presentation, remote history of traumatic injury, radiographic progression, treatment, and outcomes of 5 patients treated at Washington University for symptomatic ISCH. A video showing surgical repair is presented. In contrast to classic compressive myelopathy symptomatology, ISCH patients presented with an atypical myelopathy, characterized by asymmetric motor and sensory deficits and early-onset urinary incontinence. Clinical deterioration correlated with progressive spinal cord displacement and herniation observed on yearly spinal imaging in a patient imaged serially because of multiple sclerosis. Finally, compared with compressive myelopathy in the thoracic spine, surgical treatment of ISCH led to rapid improvement despite a long duration of symptoms.

CONCLUSION:

Symptomatic ISCH presents with atypical myelopathy and slow temporal progression and can be successfully managed with surgical repair.

PMID:
24871148
[PubMed - in process]
PMCID:
PMC4134727
[Available on 2015-09-01]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins
    Loading ...
    Write to the Help Desk