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Published on: February 24, 2023
Sciatica caused by lumbar epidural gas.
Hatim Belfquih1, Brahim El Mostarchid1, Ali Akhaddar1
1Department of Neurosurgery, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Gas accumulation from disc degeneration rarely causes nerve compression. This case highlights symptomatic epidural gas from intervertebral disc vacuum phenomenon causing sciatica, successfully treated by gas evacuation.
Area of Science:
- Neurology
- Radiology
- Orthopedics
Background:
- Disc degeneration can lead to gas formation within the intervertebral disc, known as the vacuum phenomenon.
- While often asymptomatic, this gas can rarely cause neurological symptoms by compressing neural structures.
Observation:
- A 45-year-old woman presented with chronic sciatica unresponsive to conservative treatment.
- Computed tomography (CT) revealed an intradiscal vacuum phenomenon and significant epidural gas accumulation in the lumbar region.
- The gas was observed to be compressing the dural sac and the S1 nerve root.
Findings:
- Symptomatic epidural gas accumulation originating from the vacuum phenomenon of the intervertebral disc.
- Lumbo-sacral radiculopathy was directly attributed to the nerve root compression by the epidural gas.
- CT imaging proved effective in diagnosing the gas accumulation and its compressive effects.
Implications:
- This case underscores that symptomatic epidural gas from disc degeneration, though rare, can mimic common sciatica.
- Prompt diagnosis via CT and surgical evacuation of the gas can lead to complete symptom resolution.
- Highlights the importance of considering less common causes of radiculopathy in clinical practice.
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