Transdural herniation of the cervical spinal cord as a complication of a broken fracture-fixation wire.

Herniation of the spinal cord through a dural rent is a rare occurrence. Although sporadic cases have been documented, the diagnosis has never been made preoperatively [1 -3J . We report a case of a transdural cord herniation at the C1 C2 level. The dural tear was a result of penetration by a broken fracture-fi xation wire and its subsequent complications. Transdural spinal cord herniation was demonstrated preoperatively by CT metrizamide myelography and MR imaging. Although conventional myelography did not demonstrate the hernia directly, it did reveal characteristic myelographic findings. To our knowledge, the complication of a broken fracturefi xation wire penetrating the dura has not been previously reported. Tears in the spinal dura require surgical closure to prevent nerve root entrapment, meningitis, or cord herniation .