Idiopathic Spinal Cord Herniation (특발성 척수 탈출증)

김성수

Idiopathic Spinal Cord Herniation

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2017, 24(2), pp.121-128
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

김성수 ¹

¹인제대학교

Accredited

ABSTRACT

Study Design: Literature review. Objectives: The aim of this study was to provide insight into idiopathic spinal cord herniation (ISCH) in terms of clinical presentation, pathophysiology, diagnosis, classification, and treatment. Summary of Literature Review: ISCH is a rare disorder characterized by anterior displacement of the spinal cord through a ventral dural defect. It has increasingly been recognized and described over the past 10 years. Materials and Methods: Review of the English-language literature on ISCH. Results: ISCH occurs in middle-aged adults with a female preponderance. The most common clinical presentation is Brown- Sequard syndrome, which can progress to spastic paraparesis. Its pathophysiology is unknown. However, some authors proposed that inflammation may play an important role in the emergence of a dural defect. Magnetic resonance imaging typically shows an anterior kink of the thoracic spinal cord with an obliteration of the ventral subarachnoid space and the widened dorsal subarachnoid space. Surgery is generally recommended for patients with motor deficits or progressive neurological symptoms. The posterior approach has been used because it allows wide exposure of the spinal cord. The surgical treatment of ISCH consists of spinal cord reduction from the ventral dural defect, which can be managed with enlargement, direct repair, or duraplasty (dural repair with a patch). In recent years, duraplasty has been used more frequently than enlargement of the dural defect. Conclusions: ISCH causing thoracic myelopathy could be safely treated with surgical management. The possibility of this disease should be kept in mind when treating patients with progressive myelopathy.

KEYWORDS

Spinal cord herniation, Idiopathic cord herniation, Dural defect, Duraplasty

Citation status

* References for papers published after 2023 are currently being built.

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Journal of Korean Society of Spine Surgery 2023 KCI Impact Factor : 0.03