title: The pathophysiology, classification, treatment, and prognosis of a spontaneous thoracic spinal cord herniation: A case study with literature review.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Herniation of the thoracic cord, documented on MR, may produce symptomatic paraparesis which may resolve following laminectomy with ventral dural repair.
authors.affiliation: Department of Surgery, Division of Neurosurgery, Santa Casa de São Paulo Medical School, São Paulo - SP, Brazil.
authors.forename: Rodrigo Becco
authors.initials: RB
authors.lastname: De Souza
authors.affiliation: Department of Surgery, Division of Neurosurgery, Santa Casa de São Paulo Medical School, São Paulo - SP, Brazil.
authors.forename: Guilherme Brasileiro
authors.initials: GB
authors.lastname: De Aguiar
authors.affiliation: Department of Surgery, Division of Neurosurgery, Santa Casa de São Paulo Medical School, São Paulo - SP, Brazil.
authors.forename: Jefferson Walter
authors.initials: JW
authors.lastname: Daniel
authors.affiliation: Department of Surgery, Division of Neurosurgery, Santa Casa de São Paulo Medical School, São Paulo - SP, Brazil.
authors.forename: José Carlos Esteves
authors.initials: JC
authors.lastname: Veiga
keywords: Laminectomy; magnetic resonance imaging; microsurgery; neurosurgical procedures; spinal cord diseases