{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T10:05:35Z","timestamp":1780653935704,"version":"3.54.1"},"reference-count":6,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Iatrogenic spinal cord herniation is an exceptionally rare complication following spinal surgery involving durotomy. Failure of watertight dural closure may lead to pseudomeningocele formation and progressive spinal cord tethering, ultimately resulting in herniation and neurological deterioration.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n We report two cases of postoperative spinal cord herniation. A 36-year-old male developed acute conus medullaris herniation 2 weeks after surgical resection of a cystic lesion, presenting with paraparesis, sensory loss, and sphincter dysfunction. A 68-year-old male presented with delayed cervical spinal cord herniation 19 months after C5\u2013C7 meningioma resection, manifesting with progressive paresthesia on all four limbs. Magnetic resonance imaging demonstrated herniation of the spinal cord through a dorsal dural defect in both patients. Surgical revision consisted of extension of the previous durotomy, microsurgical lysis of arachnoid adhesions, reduction of the herniated spinal cord, and watertight dural repair using non-absorbable sutures reinforced with a collagen dural substitute and fibrin sealant. Both patients experienced significant neurological recovery, with complete symptomatic resolution in the cervical case.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Postoperative spinal cord herniation requires a high index of suspicion in any patient with delayed neurological deterioration after spinal surgery. Early surgical untethering with watertight dural closure is essential to prevent permanent deficits; pseudomeningoceles identified on postoperative imaging warrant radiological surveillance until resolution.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_468_2026","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T09:21:33Z","timestamp":1780651293000},"page":"333","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Iatrogenic postoperative spinal cord herniation: A report of two cases and review of the literature"],"prefix":"10.25259","volume":"17","author":[{"given":"Diogo Gon\u00e7alves","family":"Mesquita","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Unidade Local de Sa\u00fade de Santa Maria, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00eas Almeida","family":"Louren\u00e7o","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital de Santa Maria, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edson Santos","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Cuf Descobertas, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Livraghi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital de Santa Maria, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre Rainha","family":"Campos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital de Santa Maria, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"10.25259\/SNI_468_2026\/ref-1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1038\/s41394-022-00505-x","article-title":"Iatrogenic dorsal spinal cord herniation and repair with clip-based expansile duraplasty: A case report","volume":"8","author":"Gebreyohanes","year":"2022","journal-title":"Spinal Cord Ser Cases"},{"key":"10.25259\/SNI_468_2026\/ref-2","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1016\/j.spinee.2012.09.039","article-title":"Dorsal thoracic spinal cord herniation: Report of an unusual case and review of the literature","volume":"12","author":"Le","year":"2012","journal-title":"Spine J"},{"key":"10.25259\/SNI_468_2026\/ref-3","doi-asserted-by":"crossref","first-page":"e43","DOI":"10.1016\/j.spinee.2013.05.057","article-title":"Postoperative spinal cord herniation with pseudomeningocele in the cervical spine: A case report","volume":"13","author":"Moriyama","year":"2013","journal-title":"Spine J"},{"key":"10.25259\/SNI_468_2026\/ref-4","first-page":"383","article-title":"Postoperative iatrogenic spinal cord herniation: Three case reports with a literature review","volume":"82","author":"Nakashima","year":"2020","journal-title":"Nagoya J Med Sci"},{"key":"10.25259\/SNI_468_2026\/ref-5","doi-asserted-by":"crossref","first-page":"10","DOI":"10.51894\/001c.143749","article-title":"Iatrogenic spinal cord herniation: Systematic review of a rare postoperative complication","volume":"10","author":"Patel","year":"2025","journal-title":"Spartan Med Res J"},{"key":"10.25259\/SNI_468_2026\/ref-6","first-page":"117","article-title":"Late postoperative cervical spinal cord herniation with pseudomeningocele","volume":"154","author":"Wang","year":"2021","journal-title":"Chin J Neurosurg"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/iatrogenic-postoperative-spinal-cord-herniation-a-report-of-two-cases-and-review-of-the-literature\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/iatrogenic-postoperative-spinal-cord-herniation-a-report-of-two-cases-and-review-of-the-literature\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T09:21:35Z","timestamp":1780651295000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/iatrogenic-postoperative-spinal-cord-herniation-a-report-of-two-cases-and-review-of-the-literature\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":6,"alternative-id":["10.25259\/SNI_468_2026"],"URL":"https:\/\/doi.org\/10.25259\/sni_468_2026","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,5]]},"article-number":"333"}}