Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Focal Anterior Displacement of the Thoracic Spinal Cord without Evidence of Spinal Cord Herniation or an Intradural Mass

  • Lee, Jong Yoon (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Lee, Joon Woo (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Lee, Guen Young (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Kang, Heung Sik (Department of Radiology, Seoul National University Bundang Hospital)
  • Received : 2014.03.13
  • Accepted : 2014.07.21
  • Published : 2014.12.01
⟨ Previous Next ⟩

Abstract

Objective: We report magnetic resonance imaging (MRI) findings on focal anterior displacement of the thoracic spinal cord in asymptomatic patients without a spinal cord herniation or intradural mass. Materials and Methods: We identified 12 patients (male:female = 6:6; mean age, 51.7; range, 15-83 years) between 2007 and 2011, with focal anterior displacement of the spinal cord and without evidence of an intradural mass or spinal cord herniation. Two radiologists retrospectively reviewed the MRI findings in consensus. Results: An asymmetric spinal cord deformity with a focal dented appearance was seen on the posterior surface of the spinal cord in all patients, and it involved a length of 1 or 2 vertebral segments in the upper thoracic spine (thoracic vertebrae 1-6). Moreover, a focal widening of the posterior subarachnoid space was also observed in all cases. None of the patients had myelopathy symptoms, and they showed no focal T2-hyperintensity in the spinal cord with the exception of one patient. In addition, cerebrospinal fluid (CSF) flow artifacts were seen in the posterior subarachnoid space of the affected spinal cord level. Computed tomography myelography revealed preserved CSF flow in the two available patients. Conclusion: Focal anterior spinal cord indentation can be found in the upper thoracic level of asymptomatic patients without a spinal cord herniation or intradural mass.

Keywords

References

  1. Parmar H, Park P, Brahma B, Gandhi D. Imaging of idiopathic spinal cord herniation. Radiographics 2008;28:511-518 https://doi.org/10.1148/rg.282075030
  2. Groen RJ, Coppes MH. Operative treatment of posterior spinal arachnoid cysts: do not refrain from checking on an anterior transdural spinal cord herniation. Acta Neurochir (Wien) 2011;153:601-602; author reply 603 https://doi.org/10.1007/s00701-010-0892-2
  3. van den Hauwe L, Van Goethem JW, Goedseels K, Merlevede K, Degryse H, Parizel PM. Thoracic spinal cord herniation and arachnoid cyst. JBR-BTR 2006;89:150-151
  4. Dix JE, Griffitt W, Yates C, Johnson B. Spontaneous thoracic spinal cord herniation through an anterior dural defect. AJNR Am J Neuroradiol 1998;19:1345-1348
  5. Reardon MA, Raghavan P, Carpenter-Bailey K, Mukherjee S, Smith JS, Matsumoto JA, et al. Dorsal thoracic arachnoid web and the "scalpel sign": a distinct clinical-radiologic entity. AJNR Am J Neuroradiol 2013;34:1104-1110 https://doi.org/10.3174/ajnr.A3432
  6. Brus-Ramer M, Dillon WP. Idiopathic thoracic spinal cord herniation: retrospective analysis supporting a mechanism of diskogenic dural injury and subsequent tamponade. AJNR Am J Neuroradiol 2012;33:52-56 https://doi.org/10.3174/ajnr.A2730
  7. Tekkök IH. Spontaneous spinal cord herniation: case report and review of the literature. Neurosurgery 2000;46:485-491; discussion 491-492 https://doi.org/10.1097/00006123-200002000-00044
  8. Sasani M, Ozer AF, Vural M, Sarioglu AC. Idiopathic spinal cord herniation: case report and review of the literature. J Spinal Cord Med 2009;32:86-94 https://doi.org/10.1080/10790268.2009.11760757
  9. Groen RJ, Middel B, Meilof JF, de Vos-van de Biezenbos JB, Enting RH, Coppes MH, et al. Operative treatment of anterior thoracic spinal cord herniation: three new cases and an individual patient data meta-analysis of 126 case reports. Neurosurgery 2009;64(3 Suppl):ons145-ons159; discussion ons159-ons160
  10. Taylor TR, Dineen R, White B, Jaspan T. The thoracic anterior spinal cord adhesion syndrome. Br J Radiol 2012;85:e123-e129 https://doi.org/10.1259/bjr/81458631
  11. Abou-Fakhr FS, Kanaan SV, Youness FM, Hourani MH, Haddad MC. Thoracic spinal intradural arachnoid cyst: report of two cases and review of literature. Eur Radiol 2002;12:877-882 https://doi.org/10.1007/s003300100995
  12. Kumar K, Malik S, Schulte PA. Symptomatic spinal arachnoid cysts: report of two cases with review of the literature. Spine (Phila Pa 1976) 2003;28:E25-E29 https://doi.org/10.1097/00007632-200301150-00019
  13. Wang MY, Levi AD, Green BA. Intradural spinal arachnoid cysts in adults. Surg Neurol 2003;60:49-55; discussion 55-56 https://doi.org/10.1016/S0090-3019(03)00149-6
  14. Najjar MW, Baeesa SS, Lingawi SS. Idiopathic spinal cord herniation: a new theory of pathogenesis. Surg Neurol 2004;62:161-170; discussion 170-171 https://doi.org/10.1016/j.surneu.2003.10.030

Cited by

  1. Pathophysiology and Grading of the Ventral Displacement of Dorsal Spinal Cord Spectrum vol.12, pp.2, 2014, https://doi.org/10.4184/asj.2018.12.2.224