Hypertrophic spinal pachymeningitis: A case report

Study Design. This is a case report and review of the literature. Objective. To describe the clinical findings and the surgical treatment of a 28-year-old man with hypertrophic spinal pachymeningitis in the thoracic and lumbar region managed by expansive laminoplasty. Summary of Background Data. Hypertrophic spinal pachymeningitis is extremely rare. No description of findings present after expansive laminoplasty for hypertrophic spinal pachymeningitis has been reported. Methods. The clinical findings, course, and surgical treatment of a 28-year-old man with a hypertrophic spinal pachymeningitis are presented. The patient required expansive laminoplasty. The follow-up period after the surgical procedure was 4.2 years. Results. An unusual etiology of spinal cord compression by thickened dura mater was found with a contrast ring- or crescent-shaped enhancement on gadopentetate magnetic resonance imaging. Spasticity disappeared after the patient underwent expansive laminoplasty. Conclusion. This is the first report of a patient with hypertrophic spinal pachymeningitis treated with expansive laminoplasty. Spinal canal decompression and autogenous bone grafting are accepted treatments in the young patient. Careful observation of the patient to watch for local progression is necessary.