Tekkök I H
Department of Neurosurgery, Bayindir Medical Center, Ankara, Turkey.
Neurosurgery. 2000 Feb;46(2):485-91; discussion 491-2. doi: 10.1097/00006123-200002000-00044.
Spontaneous herniation of the spinal cord substance through a previously uninjured and/or untouched dura is a very exceptional occurrence. Spontaneous spinal cord herniation, which was first reported 25 years ago, is a cause of myelopathy that is treatable but difficult to diagnose.
A 49-year-old female patient who presented with a 3-year history of a burning sensation and hyperesthesia in her right leg and a 3-month history of left leg stiffness was diagnosed as exhibiting signs of Brown-Séquard syndrome. Magnetic resonance imaging of the thoracic spinal canal demonstrated S-shaped anterior kinking and transdural herniation of the spinal cord at the T3-T4 levels.
The patient underwent surgery via a three-level laminectomy. The herniated part of the spinal cord was microsurgically reduced, and the dural defect was repaired with Gore-Tex membrane (WL Gore & Associates, Flagstaff, AZ). The outcome of surgery was excellent.
Review of the world literature revealed 29 reported cases, with 27 of these cases being published since 1990. The clinical features, radiological diagnosis, and treatment options for this unique entity are summarized, with a synopsis of numerous misconceptions that appeared in the literature. With more familiarity with and increased awareness of this entity, more cases will be diagnosed.
脊髓实质通过先前未受伤和/或未触及的硬脊膜自发突出是一种非常罕见的情况。自发脊髓疝出于25年前首次报道，是一种可治疗但难以诊断的脊髓病病因。
一名49岁女性患者，有3年右下肢烧灼感和感觉过敏病史，以及3个月左腿僵硬病史，被诊断为表现出布朗-塞卡尔综合征的体征。胸段椎管磁共振成像显示T3 - T4水平脊髓呈S形向前扭结并经硬脊膜疝出。
患者接受了三级椎板切除术。脊髓疝出部分通过显微手术复位，硬脊膜缺损用戈尔特斯膜（WL戈尔联合公司，亚利桑那州弗拉格斯塔夫）修复。手术效果极佳。
对世界文献的回顾显示有29例报道病例，其中27例自1990年以来发表。总结了这种独特疾病的临床特征、放射学诊断和治疗选择，并概述了文献中出现的众多误解。随着对该疾病的更多了解和认识的提高，将会诊断出更多病例。
