A 66-year-old female farm worker presented with 7 years of progressive back pain and impaired motor and sphincter function. On neurological examination, she exhibited a sensory level at T4 with a spastic paraparesis and bilateral (right greater than left) muscle atrophy.[] The MR revealed a ventral dural gap at the T4 level [Figure –]. She underwent a T4 laminectomy at which time the ventral dural gap was repaired (e.g. ventral dura mater defect repaired utilizing a 5-0 prolene suture to attach a muscle/fascia patch to the surrounding healthy dura mater) and the cord was reduced [] at surgery. The herniated cord appeared “violaceous/pale” in color and was hardened []. Postoperatively, the patient showed improvement in muscle strength in the lower limbs, allowing her to walk with assistance (with a cane or walker).
A 76-year-old female presented with progressive onset difficulty in walking, leg weakness, and gait ataxia. On clinical exam, she had a sensory level T9 and T8-9 myelopathy was suspected. Lab parameters were within normal limits. There was no history of trauma. MRI thoracic spine demonstrated acute ventral kink in the thoracic spinal cord at T2-3 level [].