Biomaterial Database

Surgical treatment of idiopathic transdural spinal cord herniation: a new technique to untether the spinal cord. 2006

M P Arts, and G Lycklama à Nijeholt, and J A L Wurzer

Department of Neurosurgery, Medical Center Haaglanden, Westeinde, The Hague, The Netherlands. m.arts@mchaaglanden.nl

Idiopathic transdural spinal cord herniation is a rare but treatable cause of thoracic myelopathy caused by herniation of the spinal cord through a defect in the dura. The diagnosis is frequently missed or delayed, but the latest imaging techniques can document spinal cord herniation through a dural defect. Surgical treatment, consisting of reducing the herniation by closing the dural defect or widening the aperture to prevent spinal cord compression, is rather successful. We describe a new technique to untether the spinal cord by wrapping a dura graft around the myelum to prevent recurrent transdural herniation. Two patients and a review of the literature are discussed. We conclude that high-resolution T2 magnetic resonance imaging is the best imaging modality to detect the entity, and wrapping the myelum is an effective surgical technique to untether the spinal cord.

UI	MeSH Term	Description	Entries
D008279	Magnetic Resonance Imaging	Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.	Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D004388	Dura Mater	The outermost of the three MENINGES, a fibrous membrane of connective tissue that covers the brain and the spinal cord.	Falx Cerebelli,Falx Cerebri,Pachymeninx,Tentorium Cerebelli
D004824	Epidural Space	Space between the dura mater and the walls of the vertebral canal.	Epidural Spaces,Space, Epidural,Spaces, Epidural
D005260	Female		Females
D006547	Hernia	Protrusion of tissue, structure, or part of an organ through the bone, muscular tissue, or the membrane by which it is normally contained. Hernia may involve tissues such as the ABDOMINAL WALL or the respiratory DIAPHRAGM. Hernias may be internal, external, congenital, or acquired.	Enterocele,Hernias
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D013116	Spinal Cord	A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.	Coccygeal Cord,Conus Medullaris,Conus Terminalis,Lumbar Cord,Medulla Spinalis,Myelon,Sacral Cord,Thoracic Cord,Coccygeal Cords,Conus Medullari,Conus Terminali,Cord, Coccygeal,Cord, Lumbar,Cord, Sacral,Cord, Spinal,Cord, Thoracic,Cords, Coccygeal,Cords, Lumbar,Cords, Sacral,Cords, Spinal,Cords, Thoracic,Lumbar Cords,Medulla Spinali,Medullari, Conus,Medullaris, Conus,Myelons,Sacral Cords,Spinal Cords,Spinali, Medulla,Spinalis, Medulla,Terminali, Conus,Terminalis, Conus,Thoracic Cords