Introduzione alla diagnostica per immagini della patologia rachidea ed endorachidea - PowerPoint PPT Presentation

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Introduzione alla diagnostica per immagini della patologia rachidea ed endorachidea

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Title: Introduzione alla diagnostica per immagini della patologia rachidea ed endorachidea Author: UNIVERSITA' CATTOLICA Last modified by: a.cerase – PowerPoint PPT presentation

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Title: Introduzione alla diagnostica per immagini della patologia rachidea ed endorachidea


1
Idiopathic herniation of the thoracic spinal
cord a case report and technique note. Ulivieri
S.¹, Oliveri G.¹, Petrini C.¹, D'Elia F.2, Cuneo
G.L.3, Cerase A.4 Units of ¹Neurosurgery, and
4Neuroradiology, Santa Maria alle Scotte
Hospital, Siena, Italy 2Unit of Radiology, and
3Section of Neuroradiology, Unit of Neurology,
San Donato Hospital, Arezzo, Italy
2
  • A 35-year-old man presented with insidiously
    progressive and disabling pain in the left leg.
    There was no history of trauma or surgery
    neurological examination revealed features
    suggestive of thoracic level Brown-Séquard
    syndrome.

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  • The patient underwent a thoracic laminectomy at
    T9T10. The dura was opened under the microscope
    and an atrophic spinal cord displaced to the left
    was visible. The spinal cord was incarcerated
    through a 2.5 cm wide anterolateral dural defect
    and had an exophytic edematous appearance. In
    order to perform an anterior untethering, the
    dentate ligament was transected and the nerve
    roots were preserved. The spinal cord was gently
    mobilised out of the dural defect. Notably, there
    were no major adhaesions and thus there was no
    need to manipulate the cord. Then, it was decided
    to position hemostatic material (Spongostan) and
    glue (Tissucol) around the defect and finally a
    sheet of collagenous membrane (DuraGen) anterior
    to the spinal cord. The wound was closed in
    layers without external cerebrospinal fluid
    drainage. No spinal cord monitoring was used. The
    initial post-operative neurological deficit was
    unchanged and there was no sign of cerebrospinal
    fluid leakage. The patient was discharged seven
    days after surgery to rehabilitation.
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