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Rate ePoster

Musculoskeletal and Sports Medicine

Thoracic Spinal Stenosis Resulting in Pseudohernia: A Case Report

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Case Report Theater

    Poster Presenter(s)

  • Kristen Gambardella, Other

    Medical Student
    Medical University of South Carolina College of Medicine
    Charleston, South Carolina

    • Co-Author(s)

  • EE

    Evert Eriksson, MD

    Professor of Surgery
    Medical University of South Carolina
    Charleston, South Carolina

  • Dane Daley, MD

    Associate Professor, Orthopedic Hand Surgeon. Division Chief of Hand and Microvascular surgery
    Medical University of South Carolina
    Charleston, South Carolina

  • MS

    Matthew Sherrier, MD

    Assistant Professor of Orthopaedics and Physical Medicine & Rehabilitation
    Medical University of South Carolina
    Summerville, South Carolina

Disclosure(s):
Kristen Gambardella, Other: No financial relationships to disclose
Dane Daley, MD: No relevant disclosure to display
Case Diagnosis: Abdominal wall denervation from thoracic spinal stenosis resulted in a pseudohernia, which was diagnosed and localized with nerve conduction study (NCS) and electromyography (EMG).

Case Description or Program Description: Patient is a 64-year-old male who noticed eventration and asymmetry of the left abdominal wall one year following a left robotic inguinal hernia repair.

Setting: Tertiary care hospital.

Assessment/Results: NCS/EMG demonstrated evidence of a T6-12 radiculopathy and no evidence of a left T7-11 intercostal neuropathy. Needle evaluation of the left rectus abdominus muscle showed positive sharp waves and fibrillations more notable within the caudal aspect of the left rectus abdominis muscle when compared with the midportion and cranial aspect. Subsequent MRI of the thoracic spine demonstrated moderate left neuroforaminal stenosis at T10-11 and moderate central canal stenosis at T11-12. After discussion with neurosurgery and in the absence of severe pain or bowel and bladder dysfunction, the decision was made to clinically monitor his symptoms without surgical intervention.

Discussion (relevance): The rectus abdominus and intercostal muscles are innervated by intercostal nerves of T7-T12. Loss of innervation to the rectus abdominus and intercostal muscles can cause atrophy and eventual eventration, pain, and cosmetic issues. Though intercostal nerve injury due to trauma is a more common presentation of abdominal musculature denervation and subsequent pseudohernia, this case highlights the development of an abdominal wall pseudohernia from thoracic radiculopathy.

Conclusions: The case illustrates the application of a rarely utilized intercostal electrodiagnostic technique to diagnose and localize abdominal wall denervation. With its unique presentation, this case further elucidates the utility of intercostal nerve NCS/EMG in helping to delineate a central versus peripheral source of nerve injury.