Closed Thoracic Trauma as an Exceptional Cause of Pneumorrhachis: A Case Report

Pneumorrhachis, a rare clinical entity, refers to the presence of air in the spinal canal. Air can enter the spinal canal through various pathways, including the lungs and mediastinum (the space between the lungs), or directly from external sources due to trauma or infection. In rare cases, pneumorrhachis may result from repeated secondary Valsalva maneuvers, which is a complication of large-area pneumothorax. In this case report, we discuss a 36-year-old male patient who was involved in a high-intensity road accident. The injury assessment revealed significant findings including a large left pneumothorax, a right pneumothorax, multiple rib fractures, and the presence of pneumorrhachis. The entry of air into the spinal canal originated from the pleural space, likely through injuries to the parietal pleura. Rarely reported, closed thoracic trauma is an exceptional cause of pneumorrhachis. This unique mechanism of injury has been described in a limited number of publications addressing traumatic pneumorrhachis. The identification of pneumorrhachis in a traumatized patient should prompt further investigation to explore other potential injuries that may elucidate the formation of this intraspinal gas collection.