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Idiopathic Spinal Cord Herniation : Case Report Hideo Hosoe 1 , Kazuhiko Wakahara 1 , Atsushi Akaike 1 , Yasumichi Sakaguchi 1 , Kei Miyamoto 1 , Satoshi Nozawa 1 , Akira Ohara 1 , Yutaka Nishimoto 1 , Katsuji Shimizu 1 1Department of Orthopaedic Surgery, Gifu University, School of Medicine Keyword: spinal cord herniation , 脊髄ヘルニア , duplicated dura mate , 二重硬膜 , myelopathy , 脊髄症 pp.1339-1343
Published Date 2003/10/1
DOI https://doi.org/10.11477/mf.1408100844
  • Abstract
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 We report a case of spontaneous spinal cord herniation and review the relevant literature. A 63-year-old female had a 20-year history of Brown-Séquard syndrome. Her symptoms were mainly muscle atrophy in the left lower extremity and bilateral sensory disturbance below the level of the 7th thoracic veretbra. A magnetic resonance imaging scan of the thoracic spine revealed anterior displacement and tethering of the cord at T4-T5 and a dorsal intradural arachnoid cyst. Computerized tomography following myelography showed displacement of the spinal cord. Surgery was performed via a four-level laminectomy. The left T4 nerve root and both the left and right dentate ligaments at T4 and T5 were sectioned under a microscope. The spinal cord was gently rotated, and examination of the ventral aspect of the cord revealed a defect (10×20mm) in the inner layer of the duplicated ventral dura mater through which the spinal cord had herniated. After resection of the dura around the oval hole in both the cranial and caudal directions, the spinal cord moved dorsally, and a ventral mass-like projection of the spinal cord was observed. Operative reduction of the spinal cord improved motor strength, the sensory disturbance, and bladder function. Reports of spinal cord herniation have been increasing recently and now exceed one hundred worldwide. More cases are being reported mostly because of the development of magnetic resonance imaging and increased awareness of this entity.


Copyright © 2003, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1286 印刷版ISSN 0557-0433 医学書院

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