{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T01:05:43Z","timestamp":1779843943925,"version":"3.53.1"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"21","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,5,25]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spinal cord herniation (SCH) is exceedingly rare, with most cases occurring in the ventral thoracic spine. To date, there is only one reported case in the existing literature detailing pure lateral thoracic SCH. A 23-year-old male presented with progressive thoracic myelopathy and neurological deficits. Imaging revealed a large, left-sided dural diverticulum at T3\u20134 with an impressive SCH extending out the neural foramen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The patient underwent T2\u20134 laminectomies, left T3\u20134 facetectomies, partial pediculectomies, and transverse process removal for intradural spinal cord detethering and reduction of the lateral herniation. An AlloDerm buttress was placed within the dural diverticulum laterally, and the contralateral dentate ligaments were sutured to the medial dura as secondary means of preventing reherniation and retethering. The patient remains functionally stable at 20 months postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Lateral SCH must be recognized as a distinct pathological entity requiring individualized surgical planning. Strategies should focus on preventing reherniation and mitigating tethering forces rather than attempting conventional dural repair. Coexisting spinal deformity may meaningfully influence cord dynamics and should be incorporated into both pathophysiological understanding and operative decision-making. The complexity of managing such cases underscores the need for technical discussions within the neurosurgical community.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26188\">https:\/\/thejns.org\/doi\/10.3171\/CASE26188<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26188","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:52:36Z","timestamp":1779288756000},"source":"Crossref","is-referenced-by-count":0,"title":["Technical nuances for microsurgical reduction of lateral spinal cord herniation: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Olivia E.","family":"Gilbert","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Faraj","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Quig","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, St. Luke\u2019s University Health Network, Bethlehem, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wende","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Galgano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"J Neurosurg","first-page":"631","article-title":"Spontaneous incarcerated herniation of the spinal cord into a vertebral body: a unique cause of paraplegia. Case report","volume":"41","author":"Wortzman","year":"1974","unstructured":"Wortzman GTasker RRRewcastle NBRichardson JCPearson FG.Spontaneous incarcerated herniation of the spinal cord into a vertebral body: a unique cause of paraplegia. Case report. J Neurosurg. 1974;41(5):631-635. doi:10.3171\/jns.1974.41.5.0631"},{"issue":"1","key":"bib2","series-title":"AJNR Am J Neuroradiol","first-page":"52","article-title":"Idiopathic thoracic spinal cord herniation: retrospective analysis supporting a mechanism of diskogenic dural injury and subsequent tamponade","volume":"33","author":"Brus-Ramer","year":"2012","unstructured":"Brus-Ramer MDillon WP.Idiopathic thoracic spinal cord herniation: retrospective analysis supporting a mechanism of diskogenic dural injury and subsequent tamponade. AJNR Am J Neuroradiol. 2012;33(1):52-56. doi:10.3174\/ajnr.A2730"},{"key":"bib3","series-title":"World Neurosurg","first-page":"453","article-title":"Anterior thoracic spinal cord herniation: surgical treatment and postoperative course. An individual participant data meta-analysis of 246 cases","volume":"123","author":"Groen","year":"2019","unstructured":"Groen RJMLukassen JNMBoer GJAnterior thoracic spinal cord herniation: surgical treatment and postoperative course. An individual participant data meta-analysis of 246 cases. World Neurosurg. 2019;123:453-463.e15. doi:10.1016\/j.wneu.2018.11.229"},{"issue":"3","key":"bib4","series-title":"Surg Neurol","first-page":"362","article-title":"Thoracic cord herniation through a dural defect: description of a case and review of the literature","volume":"71","author":"Ghostine","year":"2009","unstructured":"Ghostine SBaron EMPerri BJacobson PMorsette DHsu FPK.Thoracic cord herniation through a dural defect: description of a case and review of the literature. Surg Neurol. 2009;71(3):362-367. doi:10.1016\/j.surneu.2007.08.022"},{"issue":"6","key":"bib5","series-title":"Neurosurgery","first-page":"916","article-title":"Hernia of the spinal cord: case report and review of the literature","volume":"29","author":"Tronnier","year":"1991","unstructured":"Tronnier VMSteinmetz AAlbert FKScharf JKunze S.Hernia of the spinal cord: case report and review of the literature. Neurosurgery. 1991;29(6):916-919. doi:10.1227\/00006123-199112000-00021"},{"issue":"5","key":"bib6","series-title":"Neurosurgery","first-page":"1028","article-title":"Idiopathic spinal cord herniation: a treatable cause of the Brown-Sequard syndrome\u2014case report","volume":"36","author":"Borges","year":"1995","unstructured":"Borges LFZervas NTLehrich JR.Idiopathic spinal cord herniation: a treatable cause of the Brown-Sequard syndrome\u2014case report. Neurosurgery. 1995;36(5):1028-1033. doi:10.1227\/00006123-199505000-00023"},{"issue":"1","key":"bib7","series-title":"J Neurosurg","first-page":"131","article-title":"Herniation of the spinal cord. Case report","volume":"82","author":"Kumar","year":"1995","unstructured":"Kumar RTaha JGreiner AL.Herniation of the spinal cord. Case report. J Neurosurg. 1995;82(1):131-136. doi:10.3171\/jns.1995.82.1.0131"},{"issue":"7","key":"bib8","series-title":"Neurol Med Chir (Tokyo)","first-page":"364","article-title":"Idiopathic spinal cord herniation associated with calcified thoracic disc extrusion\u2014case report","volume":"43","author":"Sagiuchi","year":"2003","unstructured":"Sagiuchi TIida HTachibana SUtsuki STanaka RFujii K.Idiopathic spinal cord herniation associated with calcified thoracic disc extrusion\u2014case report. Neurol Med Chir (Tokyo). 2003;43(7):364-368. doi:10.2176\/nmc.43.364"},{"issue":"4","key":"bib9","series-title":"Clin Imaging","first-page":"288","article-title":"Transdural spinal cord herniation: pre- and postoperative MRI findings","volume":"29","author":"Karadeniz-Bilgili","year":"2005","unstructured":"Karadeniz-Bilgili MYCastillo MBernard E.Transdural spinal cord herniation: pre- and postoperative MRI findings. Clin Imaging. 2005;29(4):288-290. doi:10.1016\/j.clinimag.2004.09.001"},{"issue":"6","key":"bib10","series-title":"Neurochirurgie","first-page":"624","article-title":"A unique case of pure lateral spinal cord herniation","volume":"67","author":"Vanden Bulcke","year":"2021","unstructured":"Vanden Bulcke DBaussart BAuliac SBoulin AGaillard S.A unique case of pure lateral spinal cord herniation. Neurochirurgie. 2021;67(6):624-627. doi:10.1016\/j.neuchi.2020.12.006"},{"key":"bib11","series-title":"Oper Neurosurg","article-title":"Ventral spinal cord displacement: a guide to differentiating spinal cord herniation from dorsal arachnoid web with 2-dimensional operative video illustrations","author":"Harbert","year":"2025","unstructured":"Harbert AGilbert OEFranklin DGibbs WGalgano M.Ventral spinal cord displacement: a guide to differentiating spinal cord herniation from dorsal arachnoid web with 2-dimensional operative video illustrations. Oper Neurosurg. 2025. doi:10.1227\/ons.0000000000001724"},{"issue":"3","key":"bib12","series-title":"Neurosurgery","first-page":"ons145","article-title":"Operative treatment of anterior thoracic spinal cord herniation: three new cases and an individual patient data meta-analysis of 126 case reports","volume":"64","author":"Groen","year":"2009","unstructured":"Groen RJMMiddel BMeilof JFOperative treatment of anterior thoracic spinal cord herniation: three new cases and an individual patient data meta-analysis of 126 case reports. Neurosurgery. 2009;64(3)(suppl):ons145-159. doi:10.1227\/01.NEU.0000327686.99072.E7"},{"issue":"5","key":"bib1","series-title":"J Neurosurg","first-page":"631","article-title":"Spontaneous incarcerated herniation of the spinal cord into a vertebral body: a unique cause of paraplegia. Case report","volume":"41","author":"Wortzman","year":"1974","unstructured":"Wortzman GTasker RRRewcastle NBRichardson JCPearson FG.Spontaneous incarcerated herniation of the spinal cord into a vertebral body: a unique cause of paraplegia. Case report. J Neurosurg. 1974;41(5):631-635. doi:10.3171\/jns.1974.41.5.0631"},{"issue":"1","key":"bib2","series-title":"AJNR Am J Neuroradiol","first-page":"52","article-title":"Idiopathic thoracic spinal cord herniation: retrospective analysis supporting a mechanism of diskogenic dural injury and subsequent tamponade","volume":"33","author":"Brus-Ramer","year":"2012","unstructured":"Brus-Ramer MDillon WP.Idiopathic thoracic spinal cord herniation: retrospective analysis supporting a mechanism of diskogenic dural injury and subsequent tamponade. AJNR Am J Neuroradiol. 2012;33(1):52-56. doi:10.3174\/ajnr.A2730"},{"key":"bib3","series-title":"World Neurosurg","first-page":"453","article-title":"Anterior thoracic spinal cord herniation: surgical treatment and postoperative course. An individual participant data meta-analysis of 246 cases","volume":"123","author":"Groen","year":"2019","unstructured":"Groen RJMLukassen JNMBoer GJAnterior thoracic spinal cord herniation: surgical treatment and postoperative course. An individual participant data meta-analysis of 246 cases. World Neurosurg. 2019;123:453-463.e15. doi:10.1016\/j.wneu.2018.11.229"},{"issue":"3","key":"bib4","series-title":"Surg Neurol","first-page":"362","article-title":"Thoracic cord herniation through a dural defect: description of a case and review of the literature","volume":"71","author":"Ghostine","year":"2009","unstructured":"Ghostine SBaron EMPerri BJacobson PMorsette DHsu FPK.Thoracic cord herniation through a dural defect: description of a case and review of the literature. Surg Neurol. 2009;71(3):362-367. doi:10.1016\/j.surneu.2007.08.022"},{"issue":"6","key":"bib5","series-title":"Neurosurgery","first-page":"916","article-title":"Hernia of the spinal cord: case report and review of the literature","volume":"29","author":"Tronnier","year":"1991","unstructured":"Tronnier VMSteinmetz AAlbert FKScharf JKunze S.Hernia of the spinal cord: case report and review of the literature. Neurosurgery. 1991;29(6):916-919. doi:10.1227\/00006123-199112000-00021"},{"issue":"5","key":"bib6","series-title":"Neurosurgery","first-page":"1028","article-title":"Idiopathic spinal cord herniation: a treatable cause of the Brown-Sequard syndrome\u2014case report","volume":"36","author":"Borges","year":"1995","unstructured":"Borges LFZervas NTLehrich JR.Idiopathic spinal cord herniation: a treatable cause of the Brown-Sequard syndrome\u2014case report. Neurosurgery. 1995;36(5):1028-1033. doi:10.1227\/00006123-199505000-00023"},{"issue":"1","key":"bib7","series-title":"J Neurosurg","first-page":"131","article-title":"Herniation of the spinal cord. Case report","volume":"82","author":"Kumar","year":"1995","unstructured":"Kumar RTaha JGreiner AL.Herniation of the spinal cord. Case report. J Neurosurg. 1995;82(1):131-136. doi:10.3171\/jns.1995.82.1.0131"},{"issue":"7","key":"bib8","series-title":"Neurol Med Chir (Tokyo)","first-page":"364","article-title":"Idiopathic spinal cord herniation associated with calcified thoracic disc extrusion\u2014case report","volume":"43","author":"Sagiuchi","year":"2003","unstructured":"Sagiuchi TIida HTachibana SUtsuki STanaka RFujii K.Idiopathic spinal cord herniation associated with calcified thoracic disc extrusion\u2014case report. Neurol Med Chir (Tokyo). 2003;43(7):364-368. doi:10.2176\/nmc.43.364"},{"issue":"4","key":"bib9","series-title":"Clin Imaging","first-page":"288","article-title":"Transdural spinal cord herniation: pre- and postoperative MRI findings","volume":"29","author":"Karadeniz-Bilgili","year":"2005","unstructured":"Karadeniz-Bilgili MYCastillo MBernard E.Transdural spinal cord herniation: pre- and postoperative MRI findings. Clin Imaging. 2005;29(4):288-290. doi:10.1016\/j.clinimag.2004.09.001"},{"issue":"6","key":"bib10","series-title":"Neurochirurgie","first-page":"624","article-title":"A unique case of pure lateral spinal cord herniation","volume":"67","author":"Vanden Bulcke","year":"2021","unstructured":"Vanden Bulcke DBaussart BAuliac SBoulin AGaillard S.A unique case of pure lateral spinal cord herniation. Neurochirurgie. 2021;67(6):624-627. doi:10.1016\/j.neuchi.2020.12.006"},{"key":"bib11","series-title":"Oper Neurosurg","article-title":"Ventral spinal cord displacement: a guide to differentiating spinal cord herniation from dorsal arachnoid web with 2-dimensional operative video illustrations","author":"Harbert","year":"2025","unstructured":"Harbert AGilbert OEFranklin DGibbs WGalgano M.Ventral spinal cord displacement: a guide to differentiating spinal cord herniation from dorsal arachnoid web with 2-dimensional operative video illustrations. Oper Neurosurg. 2025. doi:10.1227\/ons.0000000000001724"},{"issue":"3","key":"bib12","series-title":"Neurosurgery","first-page":"ons145","article-title":"Operative treatment of anterior thoracic spinal cord herniation: three new cases and an individual patient data meta-analysis of 126 case reports","volume":"64","author":"Groen","year":"2009","unstructured":"Groen RJMMiddel BMeilof JFOperative treatment of anterior thoracic spinal cord herniation: three new cases and an individual patient data meta-analysis of 126 case reports. Neurosurgery. 2009;64(3)(suppl):ons145-159. doi:10.1227\/01.NEU.0000327686.99072.E7"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/11\/21\/article-CASE26188.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/11\/21\/article-CASE26188.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/11\/21\/article-CASE26188.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:39:48Z","timestamp":1779842388000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/11\/21\/article-CASE26188.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":24,"journal-issue":{"issue":"21"},"URL":"https:\/\/doi.org\/10.3171\/case26188","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]}}}