Idiopathic Ventral Spinal Cord Herniation: Video Report and Systematic Review

Iunes, Eduardo Augusto; Barletta, Enrico Affonso; Suzuki, Fernando Seiji; Belsuzarri, Telmo Augusto Barba; Paz, Daniel; Sparapani, Fábio Veiga de Castro; Onishi, Franz Jooji; Cavalheiro, Sérgio; Salati, Thiago; Benites, Vinicius De Meldau; Riechelmann, Guilherme Salemi; Joaquim, Andrei Fernandes

doi:10.1016/j.wneu.2020.04.190

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…However, enlargement will cause CSF leakage, while direct closure will increase the risk of retraction of the spinal cord due to the limited surgical window. Different materials have been used to cover the dural opening, including muscle, fascia, fat, bovine pericardium, teflon, and artificial dural grafts, with or without the use of glue or sealants, since duraplasty strategy of applying a fascial flap to the dura to cover the defect (9,33,34). Because of the limited number of cases and lack of comparative studies, the optimal graft material it is not known.…”

Section: Discussionmentioning

confidence: 99%

“…It is most commonly observed in the thoracic spine and is characterized by ventral herniation of the spinal cord into a pseudomeningocele, ruling out the possibility of iatrogenic or traumatic reason (6)(7)(8). More than 200 cases have been reported since the first case was reported in 1970s (9)(10)(11)(12). Despite advances in neuroimaging and graft materials, the natural history and optimal management strategy of ISCH is still under debate (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Dural repair with fat patch for idiopathic spinal cord herniation: operative technique and a review of seven cases

Zhang¹,

Wu²,

Liu³

et al. 2022

Ann Transl Med

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Background: Idiopathic ventral thoracic spinal cord herniation is a rare disease presented with progressive myelopathy or Brown Séquard syndrome, causing neurological deficits. There is no consensus on etiology and surgical strategy. The purpose of the present study is to report the case series using fat patch for the repair of the ventral dural defect with clinical follow up.Methods: A retrospective review of all cases of idiopathic spinal cord herniation (ISCH) at our institution was performed between January 2017 and June 2021. Clinical data were reviewed including patients' demographic information, symptoms, imaging, operative details, perioperative and postoperative courses, and clinical outcomes, and complications. Japanese Orthopedic Association (JOA) score was calculated preoperatively and postoperatively for the comparison of outcomes.Results: A total of 7 patients were included. Fat patch was applied in all cases, and artificial dural patch was also used in 2 cases. Average operating time and estimated blood loss were 3 hours and 24 minutes and 88.6 mL, respectively. Five of 7 patients improved and 2 patients remained unchanged during follow up (average, 23.4 months; range, 9-42 months). The mean recovery rate (RR) of JOA score was 17.9%. One patient experienced cerebrospinal fluid (CSF) leakage, and 1 patient suffered from surgical related spinal canal stenosis.Conclusions: Surgical treatment using fat patch is an effective strategy for the ventral dural defect repair of ISCH.

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Section: Discussionmentioning

confidence: 99%