Surgical management of Idiopathic Thoracic Spinal Cord Herniation: A Case Report

Background Idiopathic spinal cord herniation is a rare condition that involves spinal cord herniation through a defect in the ventral dura. Case Description We present a case of a 61-year-old woman who initially presented in 2016 with an approximately 1-year history of burning right lower extremity pain and gait instability. Her neurologic examination was consistent with thoracic Brown−Sequard syndrome, and spinal magnetic resonance imaging showed a focal defect in the ventral dura at the superior aspect of T4 with the left aspect of the cord herniating into the defect. In 2018, she underwent a T3−T4 laminectomy with T3 pedicle take down and medial facetectomy, with reduction of the herniated cord. Conclusions Idiopathic spinal cord herniation is an uncommon spinal cord disorder with a paucity of data reported. Our case report of a classic case of idiopathic spinal cord herniation presenting as Brown−Sequard syndrome and managed surgically will contribute to the data in this field.