title: Spinal cord herniation as a complication of en bloc, multilevel, anterior thoracic vertebrectomy for a giant cell tumor: success of posterior cord reduction and dural repair.
abstract: Iatrogenic spinal cord herniation is a rare complication following spinal stabilization surgery. The authors present a case of circumferential thoracic tumor decompression and fixation by anterior instrumentation complicated by delayed anterior spinal cord herniation. This complication resulted in progressive paraparesis 5 years after the original procedure. The patient underwent reexploration and repair of the dural defect, resulting in the reduction of the spinal cord to its normal position. The patient's paraparesis improved significantly after dural repair. Although progression of neurological deficit can be very slow, repair of the dural defect can restore normal spinal cord alignment and improve neurological deficit. To the best of the authors' knowledge, this is the first reported case of spinal cord herniation following an anterior thoracic vertebrectomy.
authors.affiliation: National Hospital for Neurology and Neurosurgery, London, United Kingdom.
authors.forename: Khandkar A
authors.initials: KA
authors.lastname: Kawsar
authors.forename: Robin
authors.initials: R
authors.lastname: Bhatia
authors.forename: Adrian C T H
authors.initials: AC
authors.lastname: Casey
mesh_terms: D000328:Adult; D004388:Dura Mater / Q000473:pathology / Q000601:surgery; D005260:Female; D005870:Giant Cell Tumors / Q000473:pathology / Q000601:surgery*; D006547:Hernia / Q000209:etiology* / Q000473:pathology; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D012086:Reoperation; D013116:Spinal Cord / Q000473:pathology / Q000601:surgery; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery
keywords: dural repair; spinal cord hernia; spinal cord reduction; technique; vertebrectomy