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A successful surgical management of spinal cord herniation in a patient with old thoracic spine fracture: a case report from Syria

Year: 2025

Type: article

Abstract: INTRODUCTION: Idiopathic spinal cord herniation is a very uncommon condition marked by the spinal cord protruding through a defect in the front part of the dura mater. Because there is limited clinical evidence available, the treatment options and outcomes for idiopathic spinal cord herniation remain unclear. We report this first case of idiopathic spinal cord herniation at the T5 level in Syria. CASE PRESENTATION: A 31-year-old Syrian man presented with a 4-year history of numbness and weakness in the right lower limb. Magnetic resonance imaging (MRI) revealed that his spinal cord was displaced ventrally at the T5 level. A surgical procedure was performed through a posterior midline approach. During the operation, a tear in the ventral dura was discovered. After the herniated tissue was repositioned, the defect was closed with sutures. After a 3-month follow-up, the lower-extremity weakness was improved, and there was no recurrence. The patient remained stable after nine months. DISCUSSION: Spinal cord herniation is a rare and challenging condition for medical practitioners because it is poorly understood. Several pathological mechanisms have been proposed, yet the term "idiopathic spinal cord herniation" remains the most common. Trauma and mechanical mechanisms are more convincing and generally accepted. CONCLUSION: Surgery's main goal is to prevent the worsening of the condition, we identify trauma as a key cause and highlight suture therapy as an effective treatment. More studies are needed to clarify the pathology and treatment options for this disease.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2025.111394

Authors: Mostafa Jaber Hassan, Iyas Salman, Rama Ahmad, Issam Salman, Eman Ali

Institutions: University of Tartus, Latakia University

Language: English

Topic: Cervical and Thoracic Myelopathy

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090