The pathophysiology, classification, treatment, and prognosis of a spontaneous thoracic spinal cord herniation: A case study with literature review

Spinal cord herniation was first described in 1974. It generally occurs in middle-aged adults in the thoracic spine. Symptoms typically include back pain and progressive paraparesis characterized by Brown-Séquard syndrome. Surgical reduction of the hernia improves the attendant symptoms and signs, even in patients with longstanding deficits. A 66-year-old female with back pain for 7 years, accompanied by paresthesias and a progressive paraparesis, underwent a thoracic MRI which documented a ventral spinal cord herniation at the T4 level. Following a laminectomy, with reduction of the hernia and ventral dural repair, the patient improved. Herniation of the thoracic cord, documented on MR, may produce symptomatic paraparesis which may resolve following laminectomy with ventral dural repair.