Idiopathic Thoracic Spinal Cord Herniation With Neurological Involvement In Operated Lumbar Spine Surgery - A Rare Case Report
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Abstract
Background: Idiopathic spinal cord herniation (ISCH) is rare ,often misdiagnosed condition without clear pathogenesis with slowly of progressive thoracic compressive myelopathy.There are less than 200 cases documented in literature.As the diagnosis is often delayed, patient may undergo unnecessary investigation which may lead to irreversible progressive neurological deterioration before confirming diagnosis. In delayed diagnosis even after surgical intervention, patients prognosis is guarded.
Case Description: We present a case of 56 yrs old female wih gradually worsening myelopathy with mainly lower limb sensory-motor symptoms.
Conclusion: Early diagnosis and treatment with surgical intervention in the patient with ISCH with a neurologic deficit results in a good prognostic outcome.
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6. Kumar R, Taha J, Greiner AL. Herniation of the spinal cord. Case report. J Neurosurg. 1995;82(1):131-6. doi: 10.3171/jns.1995.82.1.0131. [PubMed: 7815118].
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8. Imagama S, Matsuyama Y, Sakai Y, Nakamura H, Katayama Y, Ito Z, et al. Image classification of idiopathic spinal cord herniation based on symptom severity and surgical outcome: a multicenter study. J Neurosurg Spine. 2009;11(3):310-9. doi: 10.3171/2009.4.SPINE08691. [PubMed: 19769512].
9. Massicotte EM, Montanera W, Ross Fleming JF, Tucker WS, Willinsky R, TerBrugge K, et al. Idiopathic spinal cord herniation: Report of eight cases and review of the literature. Spine (Phila Pa 1976). 2002;27(9):E233-E241. doi: 10.1097/00007632-200205010-00025. [PubMed: 11979181].
10. Samuel N, Goldstein CL, Santaguida C, Fehlings MG. Spontaneous resolution of idiopathic thoracic spinal cord herniation: Case report. J Neurosurg Spine. 2015;23(3):306-8. doi: 10.3171/2014.12.SPINE14950. [PubMed: 26023901].
11. Ellger T, Schul C, Heindel W, Evers S, Ringelstein EB. Idiopathic spinal cord herniation causing progressive Brown-Sequard syndrome. Clin Neurol Neurosurg. 2006;108(4):388-91. doi: 10.1016/j.clineuro.2004.07.005. [PubMed: 16483712].
2. Darbar A, Krishnamurthy S, Holsapple JW, Hodge CJ. Ventral thoracic spinal cord herniation: frequently misdiagnosed entity. Spine (Phila Pa 1976). 2006;31(17):E600-E605. doi: 10.1097/01.brs.0000229247.69171.a1. [PubMed: 16924199].
3. Borges LF, Zervas NT, Lehrich JR. Idiopathic spinal cord herniation: A treatable cause of the Brown-Sequard syndrome- -case report. Neurosurgery. 1995;36(5):1028-32. doi: 10.1227/00006123-199505000-00023. [PubMed: 7791969].
4. Wortzman G, Tasker RR, Rewcastle NB, Richardson JC, Pearson FG. Spontaneous incarcerated herniation of the spinal cord into a vertebral body: A unique cause of paraplegia. Case report. J Neurosurg. 1974;41(5):631-5. doi: 10.3171/jns.1974.41.5.0631. [PubMed: 4424434].
5. Sioutos P, Arbit E, Tsairis P, Gargan R. Spontaneous thoracic spinal cord herniation. A case report. Spine (Phila Pa 1976). 1996;21(14):1710-3. doi: 10.1097/00007632-199607150-00019. [PubMed: 8839477].
6. Kumar R, Taha J, Greiner AL. Herniation of the spinal cord. Case report. J Neurosurg. 1995;82(1):131-6. doi: 10.3171/jns.1995.82.1.0131. [PubMed: 7815118].
7. Isu T, Iizuka T, Iwasaki Y, Nagashima M, Akino M, Abe H. Spinal cord herniation associated with an intradural spinal arachnoid cyst diagnosed by magnetic resonance imaging. Neurosurgery. 1991;29(1):137-9. doi: 10.1097/00006123-199107000-00027. [PubMed: 1870677].
8. Imagama S, Matsuyama Y, Sakai Y, Nakamura H, Katayama Y, Ito Z, et al. Image classification of idiopathic spinal cord herniation based on symptom severity and surgical outcome: a multicenter study. J Neurosurg Spine. 2009;11(3):310-9. doi: 10.3171/2009.4.SPINE08691. [PubMed: 19769512].
9. Massicotte EM, Montanera W, Ross Fleming JF, Tucker WS, Willinsky R, TerBrugge K, et al. Idiopathic spinal cord herniation: Report of eight cases and review of the literature. Spine (Phila Pa 1976). 2002;27(9):E233-E241. doi: 10.1097/00007632-200205010-00025. [PubMed: 11979181].
10. Samuel N, Goldstein CL, Santaguida C, Fehlings MG. Spontaneous resolution of idiopathic thoracic spinal cord herniation: Case report. J Neurosurg Spine. 2015;23(3):306-8. doi: 10.3171/2014.12.SPINE14950. [PubMed: 26023901].
11. Ellger T, Schul C, Heindel W, Evers S, Ringelstein EB. Idiopathic spinal cord herniation causing progressive Brown-Sequard syndrome. Clin Neurol Neurosurg. 2006;108(4):388-91. doi: 10.1016/j.clineuro.2004.07.005. [PubMed: 16483712].
| Files | ||
| Issue | Vol 11 No 1 (2025) | |
| Section | Case Report | |
| DOI | https://doi.org/10.18502/jost.v11i1.18012 | |
| Keywords | ||
| Spinal Cord Hernia Brown-Sequard Syndrome | ||
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How to Cite
1.
Shetty K, Awachat A, Gupte V, Prabhu S. Idiopathic Thoracic Spinal Cord Herniation With Neurological Involvement In Operated Lumbar Spine Surgery - A Rare Case Report. J Orthop Spine Trauma. 2025;11(1):35-8.
