Spontaneous herniation of the spinal cord: operative technique and follow-up in 10 cases

Abstract

Object: The authors report on a series of 10 patients with spontaneous thoracic cord herniation, provide the longterm follow-up, and propose a surgical strategy.

Methods: All 10 patients had a defect in the ventral dura mater. They were all treated surgically with wide excision of the dura around the defect, repositioning of the cord, and reconstruction with a ventral patch. Five patients were followed up for > 4 years.

Results: Surgery improved motor power in 4 patients and pain in 2 patients, although sensory disturbances remained unchanged in all but 1 patient. One patient's condition deteriorated secondarily due to edema and syringomyelia.

Conclusions: Microsurgical treatment may halt the exacerbation of neurological symptoms and should be performed with progressive deficits. Long-term results are good regarding the motor function.