Case of idiopathic thoracic spinal cord herniation with a chronic history: a case report and review of the literature.

Abstract

Idiopathic spinal cord herniation is a rare disease that presents with slowly progressive myelopathy. This article describes the clinical findings of a patient with a chronic history. A 68-year-old woman initially presented at the age of 32 years with left leg weakness. After slowly progressive neurological deterioration over 34 years, she became completely paraplegic. At the age of 66 years, magnetic resonance imaging resulted in a diagnosis of idiopathic spinal cord herniation at the T6/7 level. Surgery was performed to reduce aching of the lower extremities. The spinal cord was released from the dural defect through a T5-T8 laminectomy. The dural defect was enlarged by resecting its periphery to prevent reherniation of the spinal cord. After the surgery, pain in the lower extremities resolved and her motor function slightly improved. Although operative treatment is naturally recommended at the early stage of this disease, our case suggests that some symptoms can be resolved by surgical treatment despite prolonged, severe preoperative symptoms.