Lumbar radiculopathy and intraspinal gas
1Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA 98195, USA Overlake Hospital Medical Center, Bellevue, WA 98004, USA.
Journal of Back and Musculoskeletal Rehabilitation
|February 28, 2014
Summary
Intraspinal gas, a rare condition, can cause radiculopathy symptoms. This case study shows spontaneous improvement in a patient with gas in the spinal canal, highlighting its natural history.
Area of Science:
- Neurology
- Radiology
- Spinal Surgery
Background:
- Intraspinal gas is an uncommon finding, often linked to trauma, infection, disc degeneration, or vacuum phenomenon.
- Patients may present with symptoms mimicking spinal stenosis, including low back pain radiating to the lower extremities.
Purpose of the Study:
- To report a case of intraspinal gas presenting as acute radiculopathy.
- To discuss the natural history and potential complications of intraspinal gas and associated disc vacuum phenomenon.
Main Methods:
- Case report of a 73-year-old male with low back pain and left calf radiation.
- Diagnostic imaging included CT scans of the lumbar spine.
- Electrodiagnostic studies (EMG/NCS) and somatosensory evoked potentials were performed.
Main Results:
- CT revealed gas in the left lateral spinal canal at L4-S1, consistent with intraspinal gas.
- The patient experienced spontaneous improvement within 2 weeks, resuming normal activities.
- Follow-up CT showed diminished intraspinal gas, but worsened L5-S1 disc vacuum phenomenon and a new right disc extrusion.
Conclusions:
- Intraspinal gas can present with radicular symptoms and may resolve spontaneously.
- The presence of intraspinal gas may be associated with or precede disc degeneration and vacuum phenomenon.
- Close monitoring is essential to identify potential complications like disc extrusion.
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