Spinal cord herniation repair with microstaples: case report
| Autor: | Elena Araus-Galdós, Vicente Martín-Velasco, Cecilia Gil-Polo, Ana Galacho-Harriero, Javier Martín-Alonso, Pedro David Delgado-López |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Cord Hernia medicine.medical_treatment Neurosurgical Procedures Spinal Cord Diseases Thoracic Vertebrae 030218 nuclear medicine & medical imaging 03 medical and health sciences Myelopathy 0302 clinical medicine medicine Humans Spinal cord injury Reduction (orthopedic surgery) business.industry General Medicine Spinal cord medicine.disease Magnetic Resonance Imaging Sagittal plane Surgery medicine.anatomical_structure Treatment Outcome Paraparesis Spastic Etiology Female business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of neurosurgery. Spine. 26(3) |
| ISSN: | 1547-5646 |
| Popis: | Idiopathic spinal cord herniation (ISCH) is a relatively rare and frequently misdiagnosed condition. It preferentially affects women and causes progressive thoracic myelopathy that presents as a Brown-Séquard syndrome or as spastic paraparesis. Although its etiology and pathogenesis are controversial, ISCH is characterized by the presence of an anterior dural defect that allows the incarceration of a segment of the cord. Typically, a C-shaped ventral displacement and kinking of the cord are visible on sagittal MRI. Surgery aimed at stopping or reversing myelopathic symptoms is usually recommended for symptomatic patients. Surgical options include reduction of the hernia and direct suturing, or enlargement of the dural defect, with or without patching. Suturing under the cord in a very tight space can be troublesome and may lead to neurological deterioration. The authors present the case of a symptomatic ISCH in which nonpenetrating titanium microstaples were used to close the dural defect after cord reduction. The patient experienced a good outcome, and the follow-up MRI study showed adequate cord repositioning and stability of the suture. The use of microstaples, which allows for an easier and faster dural closure than conventional suturing, is a novel technical adjunct that has not been previously reported for this condition. In addition, microstaples produce minimal metallic artifact that does not hinder the quality of follow-up MR images. |
| Databáze: | OpenAIRE |
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