Idiopathic spinal cord herniation—An extremely rare cause of paraparesis: Case report

Abstract

Idiopathic spinal cord herniation is a rare disorder, consisting of a ventral displacement of the spinal cord through a dural defect. The resulting adhesion and vascular compromise lead to neurological impairment. We report the case of a 54-year-old male, with a previous urological surgery resulting in chronic vesical catheterization, with a worsening paraparesis associated with anesthesia below T10. The magnetic resonance imaging showed a ventral displacement of the spinal cord at T7/T8 with an enlarged posterior subarachnoid space at that level. A four-level laminotomy was performed followed by spinal cord herniation reduction and closure of the anterior dural defect with a dural replacement. The patient had a partial recovery of his motor deficits regaining his ability to walk with the support of a single crutch. The purpose of this study was to highlight the existence of this extremely rare cause of paraparesis, which is often misdiagnosed.