L2 radicular compression caused by a foraminal extradural gas pseudocyst

Area of Science:

• Neurology
• Radiology
• Neurosurgery

Background:

• Gas pseudocysts are an uncommon cause of lumbar radiculopathy.
• Symptomatic gas pseudocysts typically occur within the spinal canal.

Observation:

• A 67-year-old woman presented with severe right leg pain.
• Imaging revealed a gas pseudocyst compressing the L2 nerve root at the L2-3 foramen.

Findings:

• A gas pseudocyst located in the foramen, rather than the spinal canal, was identified as the cause of lumbar radiculopathy.
• Surgical excision of the gas pseudocyst was performed via a lateral transmuscular approach.

Implications:

• This case highlights the possibility of gas pseudocysts occurring ectopically in the foramen.
• Successful surgical management of foraminal gas pseudocysts can alleviate radicular pain.
• Further research may elucidate the pathogenesis and optimal treatment strategies for such rare presentations.