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Thoracic idiopathic spinal cord herniation in a young patient: a diagnostic and therapeutic challenge
  1. D Gomez-Amarillo,
  2. C Garcia-Baena,
  3. D Volcinschi-Moros and
  4. F Hakim
  1. Department of Surgery, Neurosurgery Section, Hospital Universitario Fundacion Santa Fe de Bogota, Bogota, Colombia
  1. Correspondence to Dr F Hakim, f.hakimd{at}


Idiopathic Spinal Cord Herniation (ISCH) is considered to be a rare cause of Thoracic Myelopathy. It is secondary to the gliding of the Spinal Cord through an anterior dural defect, without a completely defined cause. We present a case of ISCH which, even though was in its usual location, developed in a woman at a younger age than expected. The patient was 20 years old when diagnosed with Brown-Séquard Syndrome. MRI showed herniation at T4-T5 level, which was corrected using a posterior approach to expose the dural defect, reduce the herniation and place a heterologous graft. Postoperatively, neurological function improved, and adequate reduction was seen on imaging. Given the reports of recurrence and deterioration that have been seen after 18 months, follow-up was prolonged for a total of 2 years. We consider postoperative MRI performance important to establish the degree of reduction and alignment of the Spinal Cord.

  • spinal cord
  • neuroimaging
  • neurosurgery
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  • Contributors FH and DGA conceived the presented idea. CGB and DVM collaborated with the writing of the manuscript. FH encouraged DGA to investigate medullary hernia and supervised the work. All authors discussed the work and contributed to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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