title: Thoracic cord herniation and associated intra-operative nuances: a report.
abstract: BACKGROUND
  Thoracic cord herniation is a well-established entity in the literature. Majority of the published literature deals with its surgical management in terms of "mere" detethering of cord. However, not much is written about the degree of herniation and ectopic cord tissue and its management. A 58-year-old male presented to us with progressive difficulty in walking. Imaging revealed a cord herniation at T7-8 level. Surgical detethering was planned. However, a significant amount of "ectopic" cord tissue was found outside the dural defect intra-operatively. Simple detethering and repositioning was difficult. Hence, the ectopic tissue was excised under neuro-physiologic monitoring and no major change was recorded intra-operatively/post-operatively.
  
  
  CONCLUSIONS
  Thoracic cord herniation surgery may be more than simple detethering and cord repositioning. If encountered in similar situations intra-operatively, surgeons should be able to excise ectopic tissue without grave post-operative deficits. Neuronal plasticity probably plays an important role in the pathophysiology of long-standing cord herniation.
authors.affiliation: Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, 500082, AP, India, drashishmch@hotmail.com.
authors.forename: Ashish
authors.initials: A
authors.lastname: Kumar
authors.forename: Leodante
authors.initials: L
authors.lastname: Dacosta
mesh_terms: D002828:Choristoma / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006547:Hernia / Q000150:complications / Q000175:diagnosis; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013116:Spinal Cord / Q000601:surgery*; D013118:Spinal Cord Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013904:Thoracic Vertebrae