Hassan Mostafa Jaber, Salman Iyas, Ahmad Rama, Salman Issam, Ali Eman
Department of Neurosurgery, Tartous University, Tartous, Syrian Arab Republic.
Faculty of Medicine, Latakia University, Latakia, Syrian Arab Republic.
Int J Surg Case Rep. 2025 Jun;131:111394. doi: 10.1016/j.ijscr.2025.111394. Epub 2025 Apr 29.
Idiopathic spinal cord herniation is a very uncommon condition marked by the spinal cord protruding through a defect in the front part of the dura mater. Because there is limited clinical evidence available, the treatment options and outcomes for idiopathic spinal cord herniation remain unclear. We report this first case of idiopathic spinal cord herniation at the T5 level in Syria.
A 31-year-old Syrian man presented with a 4-year history of numbness and weakness in the right lower limb. Magnetic resonance imaging (MRI) revealed that his spinal cord was displaced ventrally at the T5 level. A surgical procedure was performed through a posterior midline approach. During the operation, a tear in the ventral dura was discovered. After the herniated tissue was repositioned, the defect was closed with sutures. After a 3-month follow-up, the lower-extremity weakness was improved, and there was no recurrence. The patient remained stable after nine months.
Spinal cord herniation is a rare and challenging condition for medical practitioners because it is poorly understood. Several pathological mechanisms have been proposed, yet the term "idiopathic spinal cord herniation" remains the most common. Trauma and mechanical mechanisms are more convincing and generally accepted.
Surgery's main goal is to prevent the worsening of the condition, we identify trauma as a key cause and highlight suture therapy as an effective treatment. More studies are needed to clarify the pathology and treatment options for this disease.
特发性脊髓疝是一种非常罕见的疾病，其特征是脊髓通过硬脑膜前部的缺损突出。由于现有临床证据有限，特发性脊髓疝的治疗选择和结果仍不明确。我们报告叙利亚首例T5水平的特发性脊髓疝病例。
一名31岁的叙利亚男性，有4年右下肢麻木和无力病史。磁共振成像（MRI）显示其脊髓在T5水平腹侧移位。通过后正中入路进行了手术。术中发现腹侧硬脑膜撕裂。将疝出组织复位后，用缝线缝合缺损。经过3个月的随访，下肢无力症状改善，无复发。9个月后患者情况稳定。
脊髓疝对医生来说是一种罕见且具有挑战性的疾病，因为对此了解甚少。已经提出了几种病理机制，但“特发性脊髓疝”这一术语仍然最为常用。创伤和机械机制更具说服力且普遍被接受。
手术的主要目标是防止病情恶化，我们确定创伤是关键原因，并强调缝合治疗是一种有效的治疗方法。需要更多研究来阐明该疾病的病理和治疗选择。
