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Idiopathic spinal cord herniation with duplicated dura mater and dorsal subarachnoid septum. Report of a case and review of the literature.

Norio Yamamoto, MD,1 Shinsuke Katoh, MD, PhD,2 Kousaku Higashino MD,PhD,1 Koichi Sairyo, MD, PhD1

1Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan 2Department of Rehabilitation, Tokushima University Hospital, Tokushima, Japan

Abstract

Background

Idiopathic spinal cord herniation (ISCH) is a rare condition and its pathogenesis remains unclear. The purpose of this case report is to present an ISCH case with dorsal subarachnoid septum suggesting the pathogenesis of ISCH being adhesions from preexisting inflammation.

Methods 

Single case report.

Results

A 60-year-old woman presented with Brown-Séquard syndrome below the level of T6. Magnetic resonance imaging revealed the thoracic spinal cord was displaced ventrally, and the dorsal subarachnoid space was enlarged and had a septum between the spinal cord and dura mater. Intraoperatively, the dorsal dura mater was seen to be adherent and the subarachnoid septum was identified after durotomy. The inner layer defect of the duplicated dura mater was found in the ventral dura mater, through which the spinal cord had herniated. After releasing the septum, the adhesions around the dura mater, and the hiatus, the spinal cord was reduced.

Conclusions

The present case indicates that adhesions around the dura mater can be the pathogenesis of ISCH.

keywords: 
Spinal cord herniation, Subarachnoid septum, Adhesion, Dura mater
Volume 8 Article 29
doi: 
10.14444/1029