title: Surgical technique for idiopathic spinal cord herniation: the Hammock method. Technical note.
abstract: Idiopathic spinal cord herniation is a rare disease, and surgical treatment is recommended for patients with motor deficits or progressive neurological symptoms. Surgery is performed to release and reposition the tethered spinal cord. In terms of repositioning and prevention of reherniation, various procedures have been proposed; enlargement of the ventral dural defect, primary closure of the defect with sutures, and insertion of a ventral patch for duraplasty. We treated 3 patients with idiopathic spinal cord herniation, using a ventral patch for duraplasty with an expanded polytetrafluoroethylene pericardial membrane (the Hammock method), and all 3 cases had good clinical outcome. The specific important technical aspects are described and illustrated. If this procedure is performed meticulously under the microscope by following the specific techniques, the Hammock method is safer and more effective for prevention of reherniation than simple enlargement of the dural defect.
authors.affiliation: Department of Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki, Japan. akutsuh@md.tsukuba.ac.jp
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Akutsu
authors.forename: Tomoya
authors.initials: T
authors.lastname: Takada
authors.forename: Kei
authors.initials: K
authors.lastname: Nakai
authors.forename: Kyoji
authors.initials: K
authors.lastname: Tsuda
authors.forename: Masataka
authors.initials: M
authors.lastname: Sakane
authors.forename: Ikuo
authors.initials: I
authors.lastname: Aita
authors.forename: Akira
authors.initials: A
authors.lastname: Matsumura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006547:Hernia / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009436:Neural Tube Defects / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D013118:Spinal Cord Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*