Spinal cord herniation following cervical meningioma excision: a rare clinical entity and review of literature

Abstract

Background: Spinal cord herniation following surgery is an extremely uncommon clinical condition with very few reports in published literature. This condition usually occurs as a spontaneous idiopathic phenomenon often in the thoracic spine or following a scenario of post traumatic spinal cord/nerve root injury. Rarely has it been reported following spinal cord tumor surgery.

Purpose: To document a case of cervical spinal cord herniation as a late onset complication following spinal cord tumor surgery with an atypical presentation of monoparesis.

Design: Case report.

Methods: We describe the clinical presentation, operative procedure, post operative outcome and review of literature of this rare clinical condition.

Results: A 57-year-old man presented with right upper limb monoparesis due to a spinal cord herniation 6 years after a cervical intradural meningioma excision. The patients underwent surgery to reduce the herniation and duroplasty with subsequent complete resolution of symptoms.

Conclusions: Spinal cord herniation must be considered as differential diagnosis in scenarios of spinal cord tumor excision presenting with late onset neurological deficit. These cases may present as paraparesis, Brown-sequard syndrome and rarely as in our case as monoparesis.

Keywords: Cervical meningioma; Monoparesis; Post-operative; Pseudomeningocoele; Spinal cord herniation.