Idiopathic hernation of the spinal cord:: Review of the literature and own experience

Idiopathic spinal cord herniation is a rare cause of thoracic myelopathy and arachnoid cyst is typical misdiagnosis. A review of the literature and an own experience with this disease were given. A 75-year-old woman was admitted with an incomplete paraplegia, unable to walk. MRI and postmyelo-CT of the thoracic spinal canal revealed spinal cord herniation at the level of T 5/6. After reposition of the spinal cord and ventral duraplasty (Gore-Tex) via hemilaminectomy/facetectomy, the patient showed improvement of motor function and therefore was able to walk. 47 surgically proven cases with no past history of spine trauma or surgery were found in the literature. In all cases herniation occurred in the thoracic spine. There was a clear female predominance. Frequently, surgery revealed a defect of the ventral dura mater. Postoperatively, most of the patients showed neurological improvement. Therefore, operative treatment should be offered. Goals of surgery are to return the spinal cord to the normal position and prevent the recurrence of herniation by closure or enlargement of the ventral dura defect.