[Nerve root compression by gas containing lumbar disc herniation--case report]
Hiroki Yasuoka1, Osamu Nemoto, Masahisa Kawaguchi
1Orthopaedic Surgery, Japan Self-Defence Force Central Hospital, 1-2-24 Ikejiri, Setagaya-ku, Tokyo 154-8532, Japan.
Brain and Nerve = Shinkei Kenkyu No Shinpo
|June 17, 2009
Summary
A rare gas-containing disc herniation at L4/5 caused leg pain. Surgical release of the intradiscal gas relieved nerve root compression and pain, offering a successful treatment for this uncommon condition.
Area of Science:
- Radiology
- Neurosurgery
- Orthopedics
Background:
- The vacuum phenomenon, or gas collection in the intervertebral disc, is seen in 1-20% of plain radiographs.
- Gas-containing disc herniations are infrequently observed, making them diagnostically challenging.
Observation:
- A 48-year-old man presented with recurrent left leg pain due to an L4/5 gas-containing disc herniation.
- Initial symptoms were relieved by an epidural block, but recurred 10 months later.
- Imaging (CT, MRI, discography) confirmed intradiscal gas compressing the L5 nerve root.
Findings:
- Surgical exploration revealed a gas mass compressing the L5 nerve root.
- Rupture of the gas mass during surgery led to immediate nerve root decompression.
- The patient experienced complete pain relief post-surgery.
Implications:
- This case highlights the importance of considering gas-containing disc herniations in the differential diagnosis of sciatica.
- Surgical decompression may be an effective treatment for symptomatic gas-containing disc herniations.
- Understanding the vacuum phenomenon's role in disc pathology is crucial for accurate diagnosis and management.
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