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Case Reports
. 2013 May;22 Suppl 3(Suppl 3):S399-403.
doi: 10.1007/s00586-012-2515-5. Epub 2012 Sep 27.

Posterior spinal cord herniation: a novel occurrence following surgery for an intramedullary cyst at the thoracolumbar junction

Rasheed Zakaria  1 , Jonathan R Ellenbogen, Ishvinder S Grewal, Neil Buxton
Affiliations
Case Reports

Posterior spinal cord herniation: a novel occurrence following surgery for an intramedullary cyst at the thoracolumbar junction

Rasheed Zakaria et al. Eur Spine J. 2013 May.

Abstract

Background: Dorsal herniation of the spinal cord through the dura is an uncommon phenomenon and this is only the fifth reported case in the thoracolumbar spine, the first following surgery at the thoracolumbar junction.

Case: A 57-year-old male underwent marsupialisation of a benign intramedullary cyst at the T12-L1 level and subsequently returned with symptoms of dorsal column compromise. He was found to have a posterior herniation of the cord into a pseudomeningocele at the level of the previous surgery.

Conclusion: The hernia was reduced surgically and the defect closed directly without the need for a dural patch leading to a full recovery. Posterior cord herniation, its possible aetiologies and management strategies are discussed.

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Figures

Fig. 1
Fig. 1
Sagittal T2 weighted MRI pre-operatively demonstrating an intramedullary cyst at the thoracolumbar junction later found to be of benign, neuroenteric origin in a 57-year-old male presenting with neurogenic claudication pain
Fig. 2
Fig. 2
The patient presented 8 weeks post-operatively with a sensory level and ataxic gait with loss of lower limb proprioception. He was found to have a herniation of the cord at the previous level of surgery as shown in axial (a) and sagittal (b) T2 weighted MRI scans
Fig. 3
Fig. 3
Axial (a) and sagittal (b) T2 weighted MRI at 1-year post-operatively demonstrating resolution of the cord herniation after dural repair and the marsupialised cyst
See this image and copyright information in PMC

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