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  • Title: Thoracic idiopathic spinal cord herniation in a young patient: a diagnostic and therapeutic challenge.
    Author: Gomez-Amarillo D, Garcia-Baena C, Volcinschi-Moros D, Hakim F.
    Journal: BMJ Case Rep; 2019 May 21; 12(5):. PubMed ID: 31118170.
    Abstract:
    Idiopathic Spinal Cord Herniation (ISCH) is considered to be a rare cause of Thoracic Myelopathy. It is secondary to the gliding of the Spinal Cord through an anterior dural defect, without a completely defined cause. We present a case of ISCH which, even though was in its usual location, developed in a woman at a younger age than expected. The patient was 20 years old when diagnosed with Brown-Séquard Syndrome. MRI showed herniation at T4-T5 level, which was corrected using a posterior approach to expose the dural defect, reduce the herniation and place a heterologous graft. Postoperatively, neurological function improved, and adequate reduction was seen on imaging. Given the reports of recurrence and deterioration that have been seen after 18 months, follow-up was prolonged for a total of 2 years. We consider postoperative MRI performance important to establish the degree of reduction and alignment of the Spinal Cord.
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