Thoracic the numbness ameliorated as well. Conclusion:

Thoracic cord ventral herniation through
the dura defect is an uncommon condition causing progressive myelopathy. Most
of the cases occur spontaneously, also could be congenital or idiopathic. For
some patients there could be a history of previous thoracic surgery or trauma. The
dura defect usually needs repair to prevent progression of the myelopathy. The aim
of our report is to increase the clinical awareness of this condition
and highlight the importance of early diagnosis.


report: A
33-year-old man presented with an insidious onset and progressive numbness over
right lower chest for about 2 years. He had a history of traffic accident and
underwent a repair of right knee tendon rupture 4 years before. In the past two
years, He also experienced intermittent mild to severe upper back pain,
sometimes radiating to the neck. The pain was aggravated by cough and on
raising up from bed suddenly. He got a scald burn over right calf due to a
reduction of thermal sensation on his right lower leg. The neurological examination
revealed right leg weakness with muscle strength of 4/5 and reduced pain and
temperature sensation below right chest (about T5 level). The vibration was
also decreased on right lower limb. The spinal magnetic resonance imaging study
showed a dura ventral herniation of spinal cord at the T3,4 level. Due to the
symptomatic myelopathy, he underwent an operation of total laminectomy of T2-5
with repair of ventral dura defect. After the surgical treatment, his back pain
relieved and the numbness ameliorated as well.

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Conclusion: Symptomatic myelopathy is usually
due to compression of the spinal cord from degenerative disease, tumor, injury,
circulatory or inflammatory diseases. However ventral spinal cord herniation
through the dura defect is very rare. Most patients suffer from progressive
myelopathy for many years before the correct diagnosis is achieved. The awareness and early diagnosis are
essential to prevent irreversible neurological dysfunction.