Acta Neurochirurgica

, Volume 152, Issue 11, pp 1985–1989 | Cite as

Thoracic transdural spinal cord herniation at a level caudal to prior discectomy

Case Report


To outline a scenario of acquired transdural spinal cord herniation not previously described. The authors report their experience with a patient found to harbor a thoracic transdural spinal cord herniation at the disk space immediately caudal to a prior discectomy. Documentation of the radiographic progression of this patient’s spinal cord herniation is presented, spanning the course of 13 years. The patient underwent intradural repair of his dural defect via a lateral extracavitary approach. The herniated spinal cord was successfully reduced. The patient had modest improvement in his symptoms at 2-year follow-up. To the best of the authors’ knowledge, this case represents the first reported case documenting this anomaly at a level adjacent to that of a previous surgery within the thoracic spine.


Transdural spinal cord herniation Acquired pseudomeningocele Thoracic discectomy 



Magnetic resonance imaging


Cerebrospinal fluid




Sources of support


Conflicts of interest



  1. 1.
    Adams RF, Anslow P (2001) The natural history of transdural herniation of the spinal cord: case report. Neuroradiology 43:383–387CrossRefPubMedGoogle Scholar
  2. 2.
    Aizawa T, Sato T, Tanaka Y, Kotajima S, Sekiya M, Kokubun S (2001) Idiopathic herniation of the thoracic spinal cord: report of three cases. Spine 26:E488–E491CrossRefPubMedGoogle Scholar
  3. 3.
    Ammar KN, Pritchard PR, Matz PG, Hadley MN (2005) Spontaneous thoracic spinal cord herniation: three cases with long-term follow-up. Neurosurgery 57:E1067. doi: 00006123-200511000-00031, discussion E1067CrossRefPubMedGoogle Scholar
  4. 4.
    Aquilina K, Nanra JS, Rawluk D (2004) Idiopathic spinal cord hernia. Ir Med J 97:115–116PubMedGoogle Scholar
  5. 5.
    Barbagallo GM, Marshman LA, Hardwidge C, Gullan RW (2002) Thoracic idiopathic spinal cord herniation at the vertebral body level: a subgroup with a poor prognosis? Case reports and review of the literature. J Neurosurg 97:369–374PubMedGoogle Scholar
  6. 6.
    Barrenechea IJ, Lesser JB, Gidekel AL, Turjanski L, Perin NI (2006) Diagnosis and treatment of spinal cord herniation: a combined experience. J Neurosurg Spine 5:294–302CrossRefPubMedGoogle Scholar
  7. 7.
    Borges LF, Zervas NT, Lehrich JR (1995) Idiopathic spinal cord herniation: a treatable cause of the Brown–Sequard syndrome—case report. Neurosurgery 36:1028–1032, discussion 1032–1023CrossRefPubMedGoogle Scholar
  8. 8.
    Brugieres P, Malapert D, Adle-Biassette H, Fuerxer F, Djindjian M, Gaston A (1999) Idiopathic spinal cord herniation: value of MR phase-contrast imaging. AJNR Am J Neuroradiol 20:935–939PubMedGoogle Scholar
  9. 9.
    Cellerini M, Bayon S, Scazzeri F, Mangiafico S, Amantini A, Guizzardi GC, Giordano GP (2002) Idiopatic spinal cord herniation: a treatable cause of Brown–Sequard syndrome. Acta Neurochir (Wien) 144:321–325CrossRefGoogle Scholar
  10. 10.
    Darbar A, Krishnamurthy S, Holsapple JW, Hodge CJ Jr (2006) Ventral thoracic spinal cord herniation: frequently misdiagnosed entity. Spine 31:E600–E605CrossRefPubMedGoogle Scholar
  11. 11.
    DaSilva VR, Al-Gahtany M, Midha R, Sarma D, Cooper P (2003) Upper thoracic spinal cord herniation after traumatic nerve root avulsion. Case report and review of the literature. J Neurosurg 99:306–309PubMedGoogle Scholar
  12. 12.
    Eguchi T, Yokota H, Nikaido Y, Nobayashi M, Nishioka T (2001) Spontaneous thoracic spinal cord herniation—case report. Neurol Med Chir (Tokyo) 41:508–512CrossRefGoogle Scholar
  13. 13.
    Ellger T, Schul C, Heindel W, Evers S, Ringelstein EB (2006) Idiopathic spinal cord herniation causing progressive Brown–Sequard syndrome. Clin Neurol Neurosurg 108:388–391CrossRefPubMedGoogle Scholar
  14. 14.
    Ewald C, Kuhne D, Hassler WE (2000) Progressive spontaneous herniation of the thoracic spinal cord: case report. Neurosurgery 46:493–495, discussion 495–496CrossRefPubMedGoogle Scholar
  15. 15.
    Gwinn R, Henderson F (2004) Transdural herniation of the thoracic spinal cord: untethering via a posterolateral transpedicular approach. Report of three cases. J Neurosurg Spine 1:223–227CrossRefPubMedGoogle Scholar
  16. 16.
    Hausmann ON, Moseley IF (1996) Idiopathic dural herniation of the thoracic spinal cord. Neuroradiology 38:503–510CrossRefPubMedGoogle Scholar
  17. 17.
    Kumar R, Taha J, Greiner AL (1995) Herniation of the spinal cord. Case report. J Neurosurg 82:131–136CrossRefPubMedGoogle Scholar
  18. 18.
    Maira G, Denaro L, Doglietto F, Mangiola A, Colosimo C (2006) Idiopathic spinal cord herniation: diagnostic, surgical, and follow-up data obtained in five cases. J Neurosurg Spine 4:10–19CrossRefPubMedGoogle Scholar
  19. 19.
    Miyaguchi M, Nakamura H, Shakudo M, Inoue Y, Yamano Y (2001) Idiopathic spinal cord herniation associated with intervertebral disc extrusion: a case report and review of the literature. Spine 26:1090–1094CrossRefPubMedGoogle Scholar
  20. 20.
    Sagiuchi T, Iida H, Tachibana S, Utsuki S, Tanaka R, Fujii K (2003) Idiopathic spinal cord herniation associated with calcified thoracic disc extrusion—case report. Neurol Med Chir (Tokyo) 43:364–368CrossRefGoogle Scholar
  21. 21.
    Watters MR, Stears JC, Osborn AG, Turner GE, Burton BS, Lillehei K, Yuh WT (1998) Transdural spinal cord herniation: imaging and clinical spectra. AJNR Am J Neuroradiol 19:1337–1344PubMedGoogle Scholar
  22. 22.
    Wortzman G, Tasker RR, Rewcastle NB, Richardson JC, Pearson FG (1974) Spontaneous incarcerated herniation of the spinal cord into a vertebral body: a unique cause of paraplegia. Case report. J Neurosurg 41:631–635CrossRefPubMedGoogle Scholar

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© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Department of Neurological SurgeryUniversity of Texas, Southwestern Medical CenterDallasUSA

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