Artikel
Surgical management of patients with spontaneous spinal cord herniation
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Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: Spinal cord herniation through a dural defect is a cause of myelopathy and may occur spontaneously, after surgery or trauma. The authors report on a series of 2 patients with spontaneous thoracic cord herniation with deteriorating neurological deficits and propose a surgical strategy.
Method: Both patients presented with progressive myelopathy and had no history of previous trauma or surgery. Magnetic resonance imaging showed attachment of the spinal cord anteriorly in the thoracic spine. Surgery was performed with detachment of the spinal cord, primary watertight closure of the dura and placement of a blood patch.
Results: Our presented approach allowed a safe detachment of the spinal cord and watertight dural closure. Both patients remained free of symptom progression in the postoperative course. No procedural complications were observed.
Conclusions: Microsurgical treatment should be performed in patients with spinal cord herniation presenting with progressive symptoms of myelopathy. Microsurgical detachment of the spinal cord with watertight dural closure seems to be an effective procedure in experienced hands.