Abstract
Gas production as a part of disc degeneration can occur but rarely causes nerve compression syndromes. The clinical features are similar to those of common sciatica. CT is very useful in the detection of epidural gas accumulation and nerve root compression. We report a case of symptomatic epidural gas accumulation originating from vacuum phenomenon in the intervertebral disc, causing lumbo-sacral radiculopathy. A 45-year-old woman suffered from sciatica for 9 months. The condition worsened in recent days. Computed tomography (CT) demonstrated intradiscal vacuum phenomenon, and accumulation of gas in the lumbar epidural space compressing the dural sac and S1 nerve root. After evacuation of the gas, her pain resolved without recurrence.
Highlights
Intraspinal gas is very rare and it was first reported in 1980 by Gulati and Weinstein [1].Intradiscal gas, which is suggested to be origin of intraspinal gas,has been observed since 1910 [2], and it has been observed in radiographs since 1942 [3]
Computed tomography (CT) is very useful in the detection of epidural gas accumulation and nerve root compression [5]
We report these cases of sciatica caused by gas in the epidural space and discuss the diagnosis and management of this rare cause of sciatica
Summary
Intraspinal gas is very rare and it was first reported in 1980 by Gulati and Weinstein [1].Intradiscal gas (vacuum phenomenon), which is suggested to be origin of intraspinal gas,has been observed since 1910 [2], and it has been observed in radiographs since 1942 [3]. CT is very useful in the detection of epidural gas accumulation and nerve root compression [5]. We report these cases of sciatica caused by gas in the epidural space and discuss the diagnosis and management of this rare cause of sciatica. A 45- year-old previously healthy woman presented with a 9months history of right radicular leg pain. Epidural gas accumulation was compressing the dural sac and right S1 nerve root (Figure 1, Figure 2). Histological study revealed no specific fibrous tissue. One year after this operation, the patient remains free of pain
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