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Background: Spinal cord herniation and thoracic anterior adhesion syndrome make up the two extremes of a rare condition; characterized by anterior dural adhesion or protrusion of the spinal cord through the arachnoideal and dural membrane into the extradural space, respectively.
Summary: We present the main features of the condition by our case series and forward a hypothesis for the consistent anterior, mid-thoracic localization. We surmise the role of an anterior pulling force by the Hofmann (meningo-vertebral) ligaments; acting when the physiologic thoracic kyphosis suddenly increases. The traction may tear the anterior dura; resulting in a dural defect; it allows the nipping/ protrusion of the spinal cord.
Key messages: Because the spinal cord compression syndrome caused by adhesion or herniation of the spinal cord may be surgically treatable; the recognition of the condition is essential. The pathogenetic traction effect of the Hofmann ligament in the affected level may have surgical an prognostic implications.
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Author(s): Anna Szucs Andras Horvath Peter Varallyay Eszter Turanyi Eva Osztie Geza Szabo Attila Bago Anita Kamondi and Peter Banczerowski
Spinal cord herniation, Meningo-vertebral ligament, Dural sac, Spinal cord compression, Spinal Cord Herniation: Why Anterior Thoracic?