PMC5764918_01
Axial T2-weighted images. Right image showing normal position of the cervical cord at level C3. Left image at level C7 showing left-sided cord herniation: anterior and left-sided displacement of the cord towards the foramen of root C8 resulting in the stretching and flattening of the cord. Sagittal T2-weighted left-sided off midline image. Anterior displacement of the cord against the posterior aspect of level C4 to C6 and posterior indentation on/anterior angulation of the cord on level C7
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F1
T2-weighted magnetic resonance imaging (MRI) (1.5 T) revealed left-sided SCH at the C7 root level; this was characterized by anterior left-sided displacement of the spinal cord towards the C8 root foramen with stretching and flattening of the cord [Figure 1].
Coronal T2 myelography. Left-sided displacement of the cervical cord (arrows A) due to cord herniation. Note the prominent myelocoele (B) at level C6-C7 on the left after prior traumatic root avulsion
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F2
MR myelography demonstrated left-sided displacement of the spinal cord due to SCH as well as a prominent myelocoele at level C6-C7, the site of the prior traumatic root avulsion [Figure 2].
Intraoperative image of the SCH and the dural defect
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F3
The herniated spinal cord was reduced intradurally [Figure 3], and was covered with a Neuropatch membrane wrapped around the spinal cord (between the spinal cord and the dura, e.g. according to the Batzdorf technique) [Figures 4-9].
Intraoperative image of the Batzdorf repair of the SCH using an artificial membrane
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F4
The herniated spinal cord was reduced intradurally [Figure 3], and was covered with a Neuropatch membrane wrapped around the spinal cord (between the spinal cord and the dura, e.g. according to the Batzdorf technique) [Figures 4-9].
Cadaver image of a C6-C7 laminectomy with creation of an artificial root avulsion
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F5
The herniated spinal cord was reduced intradurally [Figure 3], and was covered with a Neuropatch membrane wrapped around the spinal cord (between the spinal cord and the dura, e.g. according to the Batzdorf technique) [Figures 4-9].
Intradural cadaver image demonstrating the root avulsion with the dural defect
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F6
The herniated spinal cord was reduced intradurally [Figure 3], and was covered with a Neuropatch membrane wrapped around the spinal cord (between the spinal cord and the dura, e.g. according to the Batzdorf technique) [Figures 4-9].
Cadaver image of the wrapping of the dural defect at the nerve root avulsion using an artificial membrane
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F7
The herniated spinal cord was reduced intradurally [Figure 3], and was covered with a Neuropatch membrane wrapped around the spinal cord (between the spinal cord and the dura, e.g. according to the Batzdorf technique) [Figures 4-9].
Cadaver image of the fixation of the artificial membrane. Note that for demonstrative purpose the dural defect is still shown
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F8
The herniated spinal cord was reduced intradurally [Figure 3], and was covered with a Neuropatch membrane wrapped around the spinal cord (between the spinal cord and the dura, e.g. according to the Batzdorf technique) [Figures 4-9].
Cadaver image of the dural closure with the artificial membrane subdural between the spinal cord and the dura
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F9
The herniated spinal cord was reduced intradurally [Figure 3], and was covered with a Neuropatch membrane wrapped around the spinal cord (between the spinal cord and the dura, e.g. according to the Batzdorf technique) [Figures 4-9].