The clinical evolution of patients with idiopathic spinal cord herniation: a case series.


Journal

Spinal cord series and cases
ISSN: 2058-6124
Titre abrégé: Spinal Cord Ser Cases
Pays: England
ID NLM: 101680856

Informations de publication

Date de publication:
09 Oct 2024
Historique:
received: 27 06 2023
accepted: 02 10 2024
revised: 25 03 2024
medline: 10 10 2024
pubmed: 10 10 2024
entrez: 9 10 2024
Statut: epublish

Résumé

Retrospective case series of 48 patients. This study's primary objective was to provide a clinical description of a group of individuals with a working diagnosis of idiopathic spinal cord herniation (ISCH). The secondary objectives were to appreciate the natural history of these patients and describe their clinical evolution with conservative or surgical management. The study was carried out at l'Hôpital de l'Enfant-Jésus, CHU de Québec (Québec, Canada), a tertiary care university hospital. This case series study is based on routinely collected data. Forty-eight (48) cases were identified as having an ISCH on MR imaging, between 2009 and 2019. Their medical files have been searched retrospectively. Patient characteristics were described according to their asymptomatic or symptomatic status. The mean age of patients at the time of diagnosis was 52.5 years. Most of the patients identified were asymptomatic (69%) and followed clinically. The main neurologic presentation for the symptomatic group was Brown-Séquard-like syndrome. 20% of the symptomatic patients were rapidly treated surgically after consultation with the neurosurgeon. The mean follow-up duration was 56 months for asymptomatic patients and 51 months for symptomatic patients. Most of our patients (41 out of 45) were considered stable or unchanged at follow-up. There was no neurological progression in all asymptomatic patients. Our study shows that ISCH and its variants are not always symptomatic and may be a fortuitous finding. As the natural history may be non-progressive, it is probably appropriate to treat some cases expectantly.

Identifiants

pubmed: 39384758
doi: 10.1038/s41394-024-00684-9
pii: 10.1038/s41394-024-00684-9
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

71

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Stéphanie Flageol (S)

Physical Medicine and Rehabilitation, CHU de Québec - Université Laval, Québec City, QC, Canada.

Sylvine Carrondo-Cottin (S)

Department of Neurosciences, CHU de Québec - Université Laval Research Centre, Québec City, QC, Canada.

André Turmel (A)

Department of Neurosciences, CHU de Québec - Université Laval Research Centre, Québec City, QC, Canada.
Neurosurgery, CHU de Québec - Université Laval, Québec City, QC, Canada.

Isabelle Côté (I)

Physical Medicine and Rehabilitation, CHU de Québec - Université Laval, Québec City, QC, Canada.
Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec City, QC, Canada.

Jérôme Paquet (J)

Department of Neurosciences, CHU de Québec - Université Laval Research Centre, Québec City, QC, Canada. jerome.paquet.med@ssss.gouv.qc.ca.
Neurosurgery, CHU de Québec - Université Laval, Québec City, QC, Canada. jerome.paquet.med@ssss.gouv.qc.ca.

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