Corredor José A, Härtl Roger
Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY.
Clin Spine Surg. 2016 Dec;29(10):415-418. doi: 10.1097/BSD.0000000000000387.
Thoracic spinal cord herniation (TSCH) is an unusual condition characterized by central displacement of the spinal cord through a dural defect, resulting in neurological impairment due to compression and vascular compromise. Different surgical techniques have been described to treat symptomatic patients with TSCH such as closure of the defect by primary sutures after reducing the spinal cord, widening the dural defect to prevent cord strangulation, or reducing the spinal cord and using a dural patch. Through a case presentation of a 62-year-old woman with TSCH, we describe step-by-step, a surgical technique for repair by reducing the spinal cord and using a dural patch. In our experience surgical reduction of the hernia will frequently improve the patient's symptoms and signs even in patients with longstanding deficits. The final objective of this surgical technique is to prevent recurrent herniation and progressive deficit.
胸段脊髓疝(TSCH)是一种罕见的病症,其特征是脊髓通过硬脊膜缺损向中央移位,因受压和血管受损而导致神经功能障碍。已描述了不同的手术技术来治疗有症状的TSCH患者,例如在脊髓复位后通过一期缝合关闭缺损、扩大硬脊膜缺损以防止脊髓绞窄,或复位脊髓并使用硬脊膜补片。通过一例62岁TSCH女性患者的病例介绍,我们逐步描述了一种通过复位脊髓并使用硬脊膜补片进行修复的手术技术。根据我们的经验,即使是有长期神经功能缺损的患者,手术复位疝通常也会改善患者的症状和体征。这种手术技术的最终目标是防止疝复发和神经功能进行性缺损。