Pneumorrhachis following cervical spine surgery
M Bautista1, J Wright2, J Pippalapalli2
1Department of Neurosurgery Leeds Teaching Hospitals NHS Trust Leeds UK.
Anaesthesia Reports
|November 25, 2021
Summary
Symptomatic pneumorrhachis, or air in the spinal canal, can occur after spinal surgery. This case study shows conservative management with oxygen therapy and supportive care effectively resolved symptoms.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neurology
Background:
- Cervical laminoplasty is a surgical procedure for spinal decompression.
- Pneumorrhachis, air within the spinal canal, is a rare complication of spinal surgery.
- Symptomatic pneumorrhachis can lead to neurological deficits.
Observation:
- A 66-year-old male developed fluctuating hemiparesis post-cervical laminoplasty.
- Imaging revealed significant extradural and intradural air in the spinal canal (pneumorrhachis).
- The patient's neurological symptoms fluctuated in severity.
Findings:
- Conservative management, including supplemental oxygen and dexamethasone, led to symptom improvement within three days.
- Full neurological recovery was observed at six weeks.
- Pneumorrhachis was successfully managed without surgical intervention.
Implications:
- Conservative measures, including oxygen therapy and patient positioning, are effective for managing symptomatic pneumorrhachis.
- Exclusion of other spinal pathologies is crucial before initiating treatment.
- Preventive strategies during surgery, such as air displacement, may reduce the incidence of pneumorrhachis.
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