PMC8422540_01
Preoperative MRI thoracic spine. (a) Sagittal view; arrow pointing to the level of the spinal cord herniation at T7-8, (b) Axial view at the level of the spinal cord herniation T7-8. MRI thoracic spine, T2-weighted sequence.
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F1
The thoracic MRI showed a ventral thecal sac irregularity with accompanying distortion of the ventral cord, consistent with "tethering;" cervical and lumbar studies were unremarkable [Figure 1].
CT myelogram. (a) Sagittal view; arrow pointing to the level of the spinal cord herniation at T7-8, (b) Axial view at the level of the spinal cord herniation at T7-8. CT myelogram.
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F2
The CT myelogram was suggestive of ventral dural tear and spinal cord herniation at the T7-8 levels and a diffuse ventral subdural fluid collection extending from T1 to T10 [Figure 2].
Intraoperative localization of T7-8 with fluoroscopy. Intraoperative localization of the level of the spinal cord herniation at T7-8 with fluoroscopy.
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F3
We performed a T7-T8 laminectomy and unilateral facetectomy with removal of the right T7 pedicle and transverse process, exposing the T7-8 nerve roots [Figure 3].
Postoperative MRI thoracic spine. (a) Sagittal view; arrow pointing to the level of the prior spinal cord herniation at T7-8, (b) Axial view at the level of the spinal cord herniation T7-8.
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F4
On repeat, MRI at 4 months postoperatively demonstrates postsurgical changes with a well-circumscribed right paraspinal fluid collection with minimal mass effect on the spinal cord [Figure 4].