Volume 9 - Continuous publishing                   Iran J Neurosurg 2023, 9 - Continuous publishing: 22-22 | Back to browse issues page

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Rahimizadeh A, Zafarshamspour S, Williamson W, Amirzadeh M, Rahimizadeh S. Idiopathic Ventral Spinal Cord Herniation: A Case Report and Review. Iran J Neurosurg 2023; 9 :22-22
URL: http://irjns.org/article-1-362-en.html
1- Pars Advanced and Minimally Invasive Medical Manners Research Center , a_rahimizadeh@hotmail.com
2- Pars Advanced and Minimally Invasive Medical Manners Research Center
Abstract:   (159 Views)
Background: Spontaneous spinal cord herniation, also known as idiopathic spinal cord herniation (ISCH), is a rare cause of progressive myelopathy that can lead to irreversible neurological deficits if left untreated. This condition is characterized by the gradual herniation of the spinal cord across a ventral defect in the dura, resulting in vascular compromise and neurological deficits. Patients typically present with Brown-Séquard syndrome or asymmetrical paraparesis. The mainstay of treatment is the reduction of the strangulated spinal cord and closing the dural defect with a synthetic patch.
Case presentation: We present the case of an adult woman with progressive asymmetrical weakness of the lower limbs compatible with spastic paraparesis. Thoracic MRI revealed characteristic features of ISCH at the T3-T4 level. Intraoperative neurophysiological monitoring was used during the surgical intervention, which involved a 3-level laminectomy, dura opening, excision of the dentate ligament, and reduction of the cord across the dural defect. The defect was then filled with an autogenous piece of muscle, followed by the closure of the defect with an artificial dural patch and dural closure. At the 6-month follow-up, the patient had shown favorable improvement.
Conclusion: Although ISCH is rare, it should be included in the differential diagnosis of patients with slowly progressive paraparesis or Brown-Séquard syndrome. Reduction of the incarcerated spinal cord followed by coverage of the dural defect may be the treatment of choice in symptomatic cases.
Type of Study: Case report | Subject: Spine

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