The potential presence of an intradural disc herniation must always be considered when performing an open discectomy on a patient whose CT scan study shows the presence of epidural gas. This association is particularly striking given the relative rarity of intradural herniations and intraspinal gas. In the event that no clear disc herniation was found, an intradural examination may be indicated to justify clinical signs and symptoms or previous radiologic studies.

The possibility of an intradural herniated disc must always be considered when performing an open discectomy on a patient whose computed tomography scan reveals the presence of epidural gas. In the event that no clear disc herniation is found to justify the clinical symptoms or the previous radiologic findings, an intradural exploration may be indicated.

An unusual case of L5 root compression caused by degenerative stenosis of L1-L2 and L2-L3 is described.

We have a point we would like to make in reference to the article entitled ''Intradural lumbar disc herniation: report of five cases with literature review'', published by Ducati et al. [1] in European Spine Journal. Our attention was drawn to the fact that this author made no reference to a number of studies previously published by us [2,3] and other authors [4,5] which mention the association of intradural herniations or cysts with gas within the spinal canal.Moreover, we had already advised in our previous study of the possible need for intradural exploration where the CT or MRI imaging studies show the existence of gas within the canal and the intraoperative findings do not explain the patient's symptoms.

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