Skip to main content
Top
Published in: European Spine Journal 1/2016

01-05-2016 | Case Report

Spinal cord herniation following cervical meningioma excision: a rare clinical entity and review of literature

Authors: Siddharth N. Aiyer, Ajoy Prasad Shetty, Rishi Kanna, Anupama Maheswaran, S. Rajasekaran

Published in: European Spine Journal | Special Issue 1/2016

Login to get access

Abstract

Background

Spinal cord herniation following surgery is an extremely uncommon clinical condition with very few reports in published literature. This condition usually occurs as a spontaneous idiopathic phenomenon often in the thoracic spine or following a scenario of post traumatic spinal cord/nerve root injury. Rarely has it been reported following spinal cord tumor surgery.

Purpose

To document a case of cervical spinal cord herniation as a late onset complication following spinal cord tumor surgery with an atypical presentation of monoparesis.

Design

Case report.

Methods

We describe the clinical presentation, operative procedure, post operative outcome and review of literature of this rare clinical condition.

Results

A 57-year-old man presented with right upper limb monoparesis due to a spinal cord herniation 6 years after a cervical intradural meningioma excision. The patients underwent surgery to reduce the herniation and duroplasty with subsequent complete resolution of symptoms.

Conclusions

Spinal cord herniation must be considered as differential diagnosis in scenarios of spinal cord tumor excision presenting with late onset neurological deficit. These cases may present as paraparesis, Brown-sequard syndrome and rarely as in our case as monoparesis.
Literature
1.
go back to reference Wortzman G, Tasker RR, Rewcastle NB, Richardson JC, Pearson FG (1974) Spontaneous incarcerated herniation of the spinal cord into a vertebral body: a unique cause of paraplegia: case report. J Neurosurg 41(5):631–635CrossRefPubMed Wortzman G, Tasker RR, Rewcastle NB, Richardson JC, Pearson FG (1974) Spontaneous incarcerated herniation of the spinal cord into a vertebral body: a unique cause of paraplegia: case report. J Neurosurg 41(5):631–635CrossRefPubMed
2.
go back to reference Kumar R, Taha J, Greiner AL (1995) Herniation of the spinal cord: case report. J Neurosurg 82(1):131–136CrossRefPubMed Kumar R, Taha J, Greiner AL (1995) Herniation of the spinal cord: case report. J Neurosurg 82(1):131–136CrossRefPubMed
3.
go back to reference Watters MR, Stears JC, Osborn AG, Turner GE, Burton BS, Lillehei K, Yuh WT (1998) Transdural spinal cord herniation: imaging and clinical spectra. Am J Neuroradiol 19(7):1337–1344PubMed Watters MR, Stears JC, Osborn AG, Turner GE, Burton BS, Lillehei K, Yuh WT (1998) Transdural spinal cord herniation: imaging and clinical spectra. Am J Neuroradiol 19(7):1337–1344PubMed
4.
go back to reference Aydin AL, Sasani M, Erhan B, Sasani H, Ozcan S, Ozer AF (2011) Idiopathic spinal cord herniation at two separate zones of the thoracic spine: the first reported case and literature review. Spine J 11(8):e9–e14CrossRefPubMed Aydin AL, Sasani M, Erhan B, Sasani H, Ozcan S, Ozer AF (2011) Idiopathic spinal cord herniation at two separate zones of the thoracic spine: the first reported case and literature review. Spine J 11(8):e9–e14CrossRefPubMed
5.
go back to reference Ijiri K, Hida K, Yano S, Komiya S, Iwasaki Y (2009) Traumatic spinal-cord herniation associated with pseudomeningocele after lower-thoracic nerve-root avulsion. Spinal Cord 47(11):829–831CrossRefPubMed Ijiri K, Hida K, Yano S, Komiya S, Iwasaki Y (2009) Traumatic spinal-cord herniation associated with pseudomeningocele after lower-thoracic nerve-root avulsion. Spinal Cord 47(11):829–831CrossRefPubMed
6.
go back to reference Dasilva VR, Al-Gahtany M, Midha R, Sarma D, Cooper P (2003) Upper thoracic spinal cord herniation after traumatic nerve root avulsion: case report and review of the literature. J Neurosurg Spine 99(3):306–309CrossRef Dasilva VR, Al-Gahtany M, Midha R, Sarma D, Cooper P (2003) Upper thoracic spinal cord herniation after traumatic nerve root avulsion: case report and review of the literature. J Neurosurg Spine 99(3):306–309CrossRef
7.
go back to reference Tanaka M, Ikuma H, Nakanishi K, Sugimoto Y, Misawa H, Takigawa T, Ozaki T (2008) Spinal cord herniation into pseudomeningocele after traumatic nerve root avulsion: case report and review of the literature. Eur Spine J 17(2):263–266CrossRefPubMedCentral Tanaka M, Ikuma H, Nakanishi K, Sugimoto Y, Misawa H, Takigawa T, Ozaki T (2008) Spinal cord herniation into pseudomeningocele after traumatic nerve root avulsion: case report and review of the literature. Eur Spine J 17(2):263–266CrossRefPubMedCentral
8.
go back to reference Yokota H, Yokoyama K, Noguchi H, Uchiyama Y (2007) Spinal cord herniation into associated pseudomeningocele after brachial plexus avulsion injury: case report. Neurosurgery 60(1):E205CrossRefPubMed Yokota H, Yokoyama K, Noguchi H, Uchiyama Y (2007) Spinal cord herniation into associated pseudomeningocele after brachial plexus avulsion injury: case report. Neurosurgery 60(1):E205CrossRefPubMed
9.
go back to reference Lee T, Lui TN, Jeng CM (1997) Spinal cord herniation after stabbing injury. Br J Neurosurg 11(1):84–86CrossRefPubMed Lee T, Lui TN, Jeng CM (1997) Spinal cord herniation after stabbing injury. Br J Neurosurg 11(1):84–86CrossRefPubMed
10.
go back to reference Sachdev VP, Huang YP, Shah CP et al (1981) Posttraumatic pseudomeningomyelocele (enlarging fracture?) in a vertebral body. Case report. J Neurosurg 54:545–549CrossRefPubMed Sachdev VP, Huang YP, Shah CP et al (1981) Posttraumatic pseudomeningomyelocele (enlarging fracture?) in a vertebral body. Case report. J Neurosurg 54:545–549CrossRefPubMed
11.
go back to reference Burres KP, Conley FK (1978) Progressive neurological dysfunction secondary to postoperative cervical pseudomeningocele in a C-4 quadriplegic: case report. J Neurosurg 48(2):289–291CrossRefPubMed Burres KP, Conley FK (1978) Progressive neurological dysfunction secondary to postoperative cervical pseudomeningocele in a C-4 quadriplegic: case report. J Neurosurg 48(2):289–291CrossRefPubMed
12.
go back to reference Belen D, Er U, Gurses L, Yigitkanli K (2009) Delayed pseudomyelomeningocele: a rare complication after foramen magnum decompression for Chiari malformation. Surg Neurol 71(3):357–361CrossRefPubMed Belen D, Er U, Gurses L, Yigitkanli K (2009) Delayed pseudomyelomeningocele: a rare complication after foramen magnum decompression for Chiari malformation. Surg Neurol 71(3):357–361CrossRefPubMed
13.
go back to reference Kawsar KA, Bhatia R, Casey AC (2014) 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: case report. J Neurosurg Spine 21(6):909–912CrossRefPubMed Kawsar KA, Bhatia R, Casey AC (2014) 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: case report. J Neurosurg Spine 21(6):909–912CrossRefPubMed
14.
go back to reference Hosono N, Yonenobu K, Ono K (1995) Postoperative cervical pseudomeningocele with herniation of the spinal cord. Spine 20(19):2147–2150CrossRefPubMed Hosono N, Yonenobu K, Ono K (1995) Postoperative cervical pseudomeningocele with herniation of the spinal cord. Spine 20(19):2147–2150CrossRefPubMed
15.
go back to reference Moriyama T, Tachibana T, Maruo K, Inoue S, Okada F, Yoshiya S (2013) Postoperative spinal cord herniation with pseudomeningocele in the cervical spine: a case report. Spine J 13(10):e43–e45CrossRefPubMed Moriyama T, Tachibana T, Maruo K, Inoue S, Okada F, Yoshiya S (2013) Postoperative spinal cord herniation with pseudomeningocele in the cervical spine: a case report. Spine J 13(10):e43–e45CrossRefPubMed
16.
go back to reference Chan YC, Mills KR (2005) The use of transcranial magnetic stimulation in the clinical evaluation of suspected myelopathy. J Clin Neurosci 12(8):878–881CrossRefPubMed Chan YC, Mills KR (2005) The use of transcranial magnetic stimulation in the clinical evaluation of suspected myelopathy. J Clin Neurosci 12(8):878–881CrossRefPubMed
17.
go back to reference Elwahab SMA, O’Sullivan MJ (2015) Spinal cord herniation after resection of cervical spinal neurofibroma with a unique presentation. Spine J 15(4):e1–e3CrossRef Elwahab SMA, O’Sullivan MJ (2015) Spinal cord herniation after resection of cervical spinal neurofibroma with a unique presentation. Spine J 15(4):e1–e3CrossRef
Metadata
Title
Spinal cord herniation following cervical meningioma excision: a rare clinical entity and review of literature
Authors
Siddharth N. Aiyer
Ajoy Prasad Shetty
Rishi Kanna
Anupama Maheswaran
S. Rajasekaran
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 1/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4412-9

Other articles of this Special Issue 1/2016

European Spine Journal 1/2016 Go to the issue