Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 11 1 2025 03 02 35 8 Kumar Shetty CONSULTANT SPINE SURGEON Amit Awachat MS ORTHOPAEDICS,FELLOWSHIP IN SPINE SURGERY Vikas Gupte CONSULTANT SPINE SURGEON Shrinivas Prabhu CONSULTANT SPINE SURGEON 2024 06 09 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. https://jost.tums.ac.ir/index.php/jost/article/view/598 https://jost.tums.ac.ir/index.php/jost/article/download/598/403