Jeong Kyung-Ho, Lee Hyun-Woo, Kwon Young-Min
Department of Neurosurgery, Dong-A University College of Medicine, Busan, Korea.
Korean J Spine. 2016 Jun;13(2):77-9. doi: 10.14245/kjs.2016.13.2.77. Epub 2016 Jun 30.
Thoracic spinal cord herniation is a rare disease cause of progressive myelopathy. Magnetic resonance image is a useful tool to diagnose preoperatively. Operation is a treatment of option. Sixty-six-year-old female visited Dong-A University Medical Center for progressive gait disturbance with falling tendency to right side. She had radiating pain and tingling sense on both leg. Sense of touch and temperature was decreased below T6 level. Both hip and knee motor power were grade IV. Magnetic resonance imaging scan showed anterior displacement of the spinal cord at T4-T5 vertebral level. Under the diagnosis of thoracic spinal cord herniation with dura defect, operation was performed for the patient with intraoperative neuromonitoring. Laminectomy at T4 and T5 level was done, and intradural exploration of the spinal cord revealed dura defect about 25mm×8mm in size. Spinal cord was released under microscope and dura defect was repaired with Lyoplant. The patient's symptom improved after the surgical procedure, but touch and temperature sense under T6 level had unchanged.
胸段脊髓疝是导致进行性脊髓病的一种罕见病因。磁共振成像（MRI）是术前诊断的有用工具。手术是一种治疗选择。一名66岁女性因进行性步态障碍且有向右侧跌倒倾向就诊于东国大学医学中心。她双腿有放射性疼痛和刺痛感。T6水平以下触觉和温度觉减退。双侧髋部和膝部肌力为IV级。磁共振成像扫描显示T4 - T5椎体水平脊髓向前移位。在诊断为伴有硬脊膜缺损的胸段脊髓疝后，对该患者进行了术中神经监测下的手术。在T4和T5水平进行了椎板切除术，硬脊膜内探查脊髓发现硬脊膜缺损，大小约为25mm×8mm。在显微镜下松解脊髓，并用Lyoplant修复硬脊膜缺损。手术后患者症状有所改善，但T6水平以下的触觉和温度觉未改变。
