Sciatica caused by epidural gas. Four case reports

Giraud, Françoise; Fontana, A; Mallet, J.-F.; Fischer, Louis; Meunier, Pierre J.

doi:10.1016/s1297-319x(01)00301-3

Cited by 24 publications

(25 citation statements)

References 7 publications

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“…Gas from vertebral disks may also be forced within intraspinal gaseous cysts or gascontaining herniations which may produce compressive radicular symptoms. Gas may also simply migrate in the epidural space (5,(24)(25). In these gaseous cysts or hernias, gas is generally injected under a certain pressure which is obtained in a stepwise fashion by a "ball-valve effect" or a "valve-pump mechanism" (1, 5).…”

Section: A B C Dmentioning

confidence: 99%

Extravertebral gas and fluid effusions associated with vertebral collapse containing a vacuum cleft possibly result from a pumping phenomenon: a new evidence of the dynamic hydro-pneumatical nature of the so-called vacuum phenomenon

Coulier

2013

Journal of the Belgian Society of Radiology

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We report two very unusual observations in which gas and fluid effusions were transiently and unexpectedly found in the extravertebral spaces of patients presenting with painful necrotic vertebral collapse containing a vacuum cleft. We hypothesize that gas and/or fluid which progressively may replace vacuum in vertebral compression fractures could be secondarily pumped through extravertebral and retroperitoneal spaces. Although being rare, these observations may represent a potential missing link in the imaging snapshots of the cyclic and dynamic vacuum phenomenon.

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Section: A B C Dmentioning

confidence: 99%

Extravertebral gas and fluid effusions associated with vertebral collapse containing a vacuum cleft possibly result from a pumping phenomenon: a new evidence of the dynamic hydro-pneumatical nature of the so-called vacuum phenomenon

Coulier

2013

Journal of the Belgian Society of Radiology

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“…18) The superior and inferior vertebrae act like pistons to push the gas out of the disc space during weight bearing. 2,5,6) This mechanism would explain the pain in the leg and not the thigh, as the gas-containing disc in the spinal canal communicated with the intervertebral disc space.…”

Section: Discussionmentioning

confidence: 99%

Gas-Containing Disc Herniations: Dual Nerve Root Compression at a Single Disc Level

Ryu

Rathi

Shin

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A 72-year-old man presented with gas-containing disc herniations resulting in dual nerve root (exiting and traversing root) compression at the single level manifesting as lower back pain with the right anterolateral thigh and medial calf pain and no response to 4 weeks of conservative treatment. Physical examination revealed positive Lasegue's sign at 409 , but the patient had no evidence of neurological deficit. Magnetic resonance imaging showed two separate disc herniations, a posterocentral herniated disc that had migrated inferiorly at the L3-4 level and compressed the L4 traversing root, and another that had compressed the L3 exiting root in the extraforaminal area at the same level. Coronal computed tomography demonstrated the presence of gas in the spinal canal and extraforaminal area at the L3-4 level, and the vacuum phenomenon was also noted at the L3-4 intervertebral disc. Microscopic discectomy was performed using midline and paramedian approaches, and the presence of gas was confirmed by bubbles after pouring saline into the area intraoperatively. Histological examination revealed fibrous tissue. The patient was discharged with complete relief of pain. This is a rare case of symptomatic gas-containing disc herniations causing dual compression of exiting and traversing roots at a single disc level.

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“…A few symptomatic cases of gas within the spine, the so-called intraspinal gas, epidural gas, or gas-containing pseudocysts, were identified by CT, MR imaging, or both. 5,6,12,26) Many patients have had a good response to conservative treatments or percutaneous procedures. 5,9,23) The present series of 18 patients with symptomatic GCDH were all treated successfully with surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of these cases have been the result of nonoperative treatments. 5,23) The present study analyzed 18 cases of disk herniation with gas associated with gas-containing disk herniations (GCDH) confirmed at surgery.…”

Section: Introductionmentioning

confidence: 99%

Surgical Experience of Gas-Containing Disk Herniation

Choi

Kim

Lee

2010

Neurol. Med. Chir.(Tokyo)

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Disk herniation with gas or gas-containing disk herniation (GCDH) is rare, although epidural gas is associated with the vacuum phenomenon. The clinical, radiologic, and surgical findings were retrospectively analyzed of 18 patients with GCDH. The demographic, clinical, and radiologic findings including computed tomography and magnetic resonance imaging, as well as operative methods were examined. The mean age was 64.4 years (range 51-84 years). All patients presented with acute radiculopathy or exacerbation of chronic pain associated with GCDH of the lumbar spine. All lumbar GCDHs were related to the vacuum phenomenon. Ruptured disks predominantly compressed the nerve root with gas in 17 cases, except in one with only compressed nerve root by gas without disk herniation. All patients had confirmed GCDH at surgery. All patients underwent removal of GCDH and five with another level of spinal stenosis or disk herniation underwent selective decompression. The six patients with instability underwent fusion. Visual analogue scale score of radicular pain was improved from 7.4 ± 0.9 before surgery to 3.2 ± 0.7 at the 3-month follow-up examination. No recurrence occurred after surgery. GCDH can occur as a space-occupying lesion in epidural space as well as a cause of radiculopathy. GCDH may indicate the source of clinical symptoms in the degenerative spine, especially combined with spinal stenosis or multiple spinal disk herniations.

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Sciatica caused by epidural gas. Four case reports

Cited by 24 publications

References 7 publications

Extravertebral gas and fluid effusions associated with vertebral collapse containing a vacuum cleft possibly result from a pumping phenomenon: a new evidence of the dynamic hydro-pneumatical nature of the so-called vacuum phenomenon

Extravertebral gas and fluid effusions associated with vertebral collapse containing a vacuum cleft possibly result from a pumping phenomenon: a new evidence of the dynamic hydro-pneumatical nature of the so-called vacuum phenomenon

Gas-Containing Disc Herniations: Dual Nerve Root Compression at a Single Disc Level

Surgical Experience of Gas-Containing Disk Herniation

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