scholarly journals Spinal Cord Suspension Using Dentate Ligament Hitch Stitches: A Novel Technique for the Repair of Ventral Spinal Cord Herniation

2017 ◽  
Vol 14 (3) ◽  
pp. 252-258 ◽  
Author(s):  
Jonathan Lui ◽  
Parag Sayal ◽  
David Choi
Keyword(s):  
Spinal Cord ◽  
Standard Technique ◽  
Resonance Imaging ◽  
Novel Technique ◽  
Early Results ◽  
Spinal Cord Herniation ◽  
Idiopathic Spinal Cord Herniation ◽  
Dural Patch ◽  
Dentate Ligament ◽  
Ventral Spinal Cord

Abstract BACKGROUND Idiopathic spinal cord herniation is usually repaired by releasing the spinal cord and inserting a dural patch to close the herniated segment of dura. However, reherniation is a potential limitation of this standard technique. OBJECTIVE To describe early results of a novel technique that utilizes the dentate ligament to hitch the spinal cord and prevent reherniation. METHODS Two patients underwent dural hernia repair and the dentate hitch technique was performed. RESULTS Restored lower limb power and mobility, and satisfactory reduction of spinal cord herniation on magnetic resonance imaging in 2 patients at 6- and 24-mo follow-ups, respectively. CONCLUSION The dentate hitch technique can achieve repair of spinal cord herniation, with satisfactory postoperative results and minimizes the risk of reherniation.

scholarly journals Idiopathic Ventral Spinal Cord Herniation: An Increasingly Recognized Cause of Thoracic Myelopathy

2014 ◽  
Vol 6 ◽  
pp. JCNSD.S16180 ◽  
Author(s):  
Jon Berg-Johnsen ◽  
Eivind Ilstad ◽  
Frode Kolstad ◽  
Mark Züchner ◽  
Jarle Sundseth
Keyword(s):  
Spinal Cord ◽  
Correct Diagnosis ◽  
Spastic Paraparesis ◽  
Dural Defect ◽  
Thoracic Myelopathy ◽  
Spinal Cord Herniation ◽  
Transient Improvement ◽  
Clinical Awareness ◽  
Idiopathic Spinal Cord Herniation ◽  
Dural Patch

Idiopathic spinal cord herniation (ISCH), where a segment of the spinal cord has herniated through a ventral defect in the dura, is a rarely encountered cause of thoracic myelopathy. The purpose of our study was to increase the clinical awareness of this condition by presenting our experience with seven consecutive cases treated in our department since 2005. All the patients developed pronounced spastic paraparesis or Brown-Séquard syndrome for several years (mean, 4.7 years) prior to diagnosis. MRI was consistent with a transdural spinal cord herniation in the mid-thoracic region in all the cases. The patients underwent surgical reduction of the herniated spinal cord and closure of the dural defect using an artificial dural patch. At follow-up, three patients experienced considerable clinical improvement, one had slight improvement, one had transient improvement, and two were unchanged. Two of the four patients with sphincter dysfunction regained sphincter control. MRI showed realignment of the spinal cord in all the patients. ISCH is probably a more common cause of thoracic myelopathy than previously recognized. The patients usually develop progressive myelopathy for several years before the correct diagnosis is made. Early diagnosis is important in order to treat the patients before the myelopathy has become advanced.

scholarly journals Thoracic ventral spinal cord herniation with progressive myelopathy – A case report and review of the literature

2021 ◽  
Vol 12 ◽  
pp. 382
Author(s):  
Taylor Anne Wilson ◽  
Ramachandran Pillai Promod Kumar ◽  
Emmanuel Omosor
Keyword(s):  
Spinal Cord ◽  
Neurological Deficits ◽  
Case Description ◽  
Review Of The Literature ◽  
Imaging Studies ◽  
Thoracic Myelopathy ◽  
Progressive Myelopathy ◽  
Spinal Cord Herniation ◽  
Idiopathic Spinal Cord Herniation ◽  
Ventral Spinal Cord

Background: Idiopathic spinal cord herniation (ISCH) is a rare, underrecognized, and often misdiagnosed entity of unclear pathogenesis that typically presents as a slowly progressive thoracic myelopathy. There are less than 200 such cases reported in the literature. ISCH diagnosis and treatment are often delayed contributing to greater fixed neurological deficits, often leading to costly, unnecessary imaging studies, and inappropriate surgery. Case Description: Here, a 48-year-old female presented with trauma-induced ISCH characterized by gradually worsening lower extremity myelopathy. Conclusion: Idiopathic spinal cord herniation (ISCH) is rare, often underdiagnosed posttraumatic myelopathy that, when accurately diagnosed and treated, can result in good outcomes.

Diagnosis and treatment of spinal cord herniation: a combined experience

2006 ◽  
Vol 5 (4) ◽  
pp. 294-302 ◽  
Author(s):  
Ignacio J. Barrenechea ◽  
Jonathan B. Lesser ◽  
Alberto L. Gidekel ◽  
Leon Turjanski ◽  
Noel I. Perin
Keyword(s):  
Spinal Cord ◽  
New York ◽  
Arachnoid Cyst ◽  
Spinal Injury ◽  
Delayed Diagnosis ◽  
Patients Âgés ◽  
Spinal Cord Herniation ◽  
Baseline Status ◽  
Idiopathic Spinal Cord Herniation ◽  
Dural Patch

Object Idiopathic spinal cord herniation (ISCH) is an uncommon clinical entity typically presenting with lower-extremity myelopathy. Despite the existence of 85 ISCH cases in the literature, misdiagnosis and delayed diagnosis remain a major concern. Methods The authors conducted a retrospective review of patients who underwent surgery for ISCH at their institutions between 1993 and 2004. Seven patients were treated for ISCH, five in New York and two in Buenos Aires. The patients’ ages ranged from 32 to 72 years. There were three men and four women. The interval between the onset of symptoms and surgery ranged from 12 to 84 months (mean 42.1 months). Preoperatively, spinal cord function in four patients was categorized as American Spinal Injury Association (ASIA) Grade D, and that in the other three patients was ASIA Grade C. In all patients a diagnosis of posterior intradural arachnoid cyst had been rendered at other institutions, and three had undergone surgery for the treatment of this entity. In all cases, the herniation was reduced and the defect repaired with a dural patch. The follow-up period ranged from 10 to 147 months (mean 49.2 months). Clinical recovery following surgery varied; however, there was no functional deterioration compared with baseline status. Syringomyelia, accompanied by neurological deterioration, developed postoperatively in two patients at 2 and 10 years, respectively. Conclusions Patients presenting with a diagnosis of posterior intradural arachnoid cyst should be evaluated carefully for the presence of an anterior spinal cord herniation. Based on the authors’ literature review and their own experience, they recommend offering surgery to patients even when neurological compromise is advanced.

Idiopathic spinal cord herniation: diagnostic, surgical, and follow-up data obtained in five cases

2006 ◽  
Vol 4 (1) ◽  
pp. 10-19 ◽  
Author(s):  
Giulio Maira ◽  
Luca Denaro ◽  
Francesco Doglietto ◽  
Annunziato Mangiola ◽  
Cesare Colosimo
Keyword(s):  
Spinal Cord ◽  
Clinical Status ◽  
Surgical Techniques ◽  
Dural Defect ◽  
Normal Position ◽  
Spinal Cord Herniation ◽  
Idiopathic Spinal Cord Herniation ◽  
Dural Patch ◽  
Postoperative Findings

✓ Idiopathic spinal cord herniation (ISCH) is a rare, although increasingly recognized, cause of myelopathy. It is the result of an anterior dural defect in the thoracic spine through which the spinal cord herniates. Surgical restoration of the herniated cord to its normal position is usually followed by significant improvement in patients' clinical status. Differing surgical techniques have been used to manage the dural defect. In this report the authors discuss the cases of five patients (four women and one man) with ISCH treated during a 13-year period. Clinical and imaging findings in each patient are reported. Two different surgical techniques were used to treat this condition: dural defect enlargement in two cases and dural patch secured with stitches in three. The intra-and postoperative findings are discussed in relation to the two surgical techniques. Based on the results and complications in these five cases, the authors now believe that ISCH should be treated, when feasible, by using a dural patch to close the dural defect at the site of the herniation.

Idiopathic spinal cord herniation: an imaging diagnosis with a significant delay

2015 ◽  
Vol 15 (9) ◽  
pp. 1943-1948 ◽  
Author(s):  
Britton J. Carter ◽  
Brent D. Griffith ◽  
Lonni R. Schultz ◽  
Muwaffak M. Abdulhak ◽  
Daniel S. Newman ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Imaging Diagnosis ◽  
Significant Delay ◽  
Spinal Cord Herniation ◽  
Idiopathic Spinal Cord Herniation

Idiopathic Spinal Cord Herniation: Case Report and Literature Review

2001 ◽  
Vol 143 (4) ◽  
pp. 401-406 ◽  
Author(s):  
P. Pereira ◽  
F. Duarte ◽  
R. Lamas ◽  
R. Vaz
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Literature Review ◽  
Spinal Cord Herniation ◽  
Idiopathic Spinal Cord Herniation

Idiopathic Spinal Cord Herniation: Case Report and Review of the Literature

Neurosurgery ◽  
1999 ◽  
Vol 44 (5) ◽  
pp. 1129-1133 ◽  
Author(s):  
Laurence A.G. Marshman ◽  
Carl Hardwidge ◽  
Suzanne C. Ford-Dunn ◽  
John S. Olney
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Review Of The Literature ◽  
Spinal Cord Herniation ◽  
Idiopathic Spinal Cord Herniation

Idiopathic Ventral Spinal Cord Herniation: Video Report and Systematic Review

2020 ◽  
Vol 139 ◽  
pp. 592-602
Author(s):  
Eduardo Augusto Iunes ◽  
Enrico Affonso Barletta ◽  
Fernando Seiji Suzuki ◽  
Telmo Augusto Barba Belsuzarri ◽  
Daniel de Araújo Paz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Herniation ◽  
Ventral Spinal Cord

scholarly journals Idiopathic Spinal Cord Herniation Associated With Calcified Thoracic Disc Extrusion-Case Report-

2003 ◽  
Vol 43 (7) ◽  
pp. 364-368 ◽  
Author(s):  
Takao SAGIUCHI ◽  
Hideo IIDA ◽  
Shigekuni TACHIBANA ◽  
Satoshi UTSUKI ◽  
Ryusui TANAKA ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Spinal Cord Herniation ◽  
Idiopathic Spinal Cord Herniation ◽  
Thoracic Disc ◽  
Disc Extrusion
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