Massicotte Eric M, Montanera Walter, Ross Fleming J F, Tucker William S, Willinsky Robert, TerBrugge Karel, Fehlings Michael G
Division of Neurosurgery and; Neuro-radiology, University of Toronto, Toronto, Ontario, Canada.
Spine (Phila Pa 1976). 2002 May 1;27(9):E233-41. doi: 10.1097/00007632-200205010-00025.
A case series of eight patients with idiopathic spinal cord herniation and a review of the literature.
To report on this rare entity, provide insight on its natural history, and propose an optimal management strategy.
Idiopathic spinal cord herniation is a rare disease with 50 cases reported before the current study.
Eight cases (follow-up 1 month to 8 years) are reported using available information from patient charts, interviews, and assessments. All imaging studies are reviewed. The review of the literature was performed using PUBMED.
Four patients, followed without surgical intervention, have not progressed. Of the three patients who underwent surgical repair by one of the authors, two improved and one was unchanged. A fourth patient, who was initially treated by another surgeon who failed to identify the dural defect and herniation, had a poor outcome.
The pathophysiology of the dural defect is still uncertain. The typical presentation is Brown-Séquard syndrome. Microsurgical repair in cases with progression of neurologic deficits is usually successful in achieving recovery of function or arrest of progression.
8例特发性脊髓疝患者的病例系列报告及文献综述。
报告这一罕见疾病，深入了解其自然病史，并提出最佳治疗策略。
特发性脊髓疝是一种罕见疾病，在本研究之前共报告过50例。
利用患者病历、访谈和评估中的可用信息报告8例病例（随访时间为1个月至8年）。对所有影像学研究进行了复查。使用PUBMED进行文献综述。
4例未经手术干预而接受随访的患者病情未进展。在由本文作者之一进行手术修复的3例患者中，2例病情改善，1例无变化。第4例患者最初由另一位未识别出硬脊膜缺损和脊髓疝的外科医生治疗，预后较差。
硬脊膜缺损的病理生理学仍不明确。典型表现为布朗 - 塞卡尔综合征。对于神经功能缺损进展的病例，显微手术修复通常能成功实现功能恢复或病情进展停止。
