Journal of Korean Neurosurgical Society

  • 제56권6호
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  • Pages.521-526
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  • 2014
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Radicular Compression by Intraspinal Epidural Gas Bubble Occurred in Distant Two Levels after Lumbar Microdiscectomy

  • Lee, Chul-Woo (Department of Neurosurgery, St. Peter's Hospital) ;
  • Yoon, Kang-Jun (Department of Neurosurgery, St. Peter's Hospital) ;
  • Ha, Sang-Soo (Department of Neurosurgery, St. Peter's Hospital) ;
  • Kang, Joon-Ki (Department of Neurosurgery, St. Peter's Hospital)
  • 투고 : 2014.04.14
  • 심사 : 2014.07.10
  • 발행 : 2014.12.28
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초록

The authors report a case of symptomatic epidural gas accumulation 2 weeks after the multi-level lumbar surgery, causing postoperative recurrent radiculopathy. The accumulation of epidural gas compressing the dural sac and nerve root was demonstrated by CT and MRI at the distant two levels, L3-4 and L5-S1, where vacuum in disc space was observed preoperatively and both laminectomy and discectomy had been done. However, postoperative air was not identified at L4-5 level where only laminectomy had been done in same surgical field, which suggested the relationship between postoperative epidural gas and the manipulation of disc structure. Conservative treatment and needle aspiration was performed, but not effective to relieve patient's symptoms. The patient underwent revision surgery to remove the gaseous cyst. Her leg pain was improved after the second operation.

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참고문헌

  1. Bosser V, Dietemann JL, Warter JM, Granel de Solignac M, Beaujeux R, Buchheit F : L5 radicular pain related to lumbar extradural gas-containing pseudocyst. Role of CT-guided aspiration. Neuroradiology 31 : 552-553, 1990 https://doi.org/10.1007/BF00340142
  2. Capelle HH, Krauss JK : Recurrent sciatica due to periligamentous trapped epidural gas after spinal sequestrectomy. J Neurosurg Spine 4 : 75-77, 2006 https://doi.org/10.3171/spi.2006.4.1.75
  3. Charles RW, Mody GM, Govender S : Pyogenic infection of the lumbar vertebral spine due to gas-forming organisms. A case report. Spine (Phila Pa 1976) 14 : 541-543, 1989 https://doi.org/10.1097/00007632-198905000-00015
  4. Cheng TM, Link MJ, Onofrio BM : Pneumatic nerve root compression : epidural gas in association with lateral disc herniation. Report of two cases. J Neurosurg 81 : 453-458, 1994 https://doi.org/10.3171/jns.1994.81.3.0453
  5. Ford LT, Gilula LA, Murphy WA, Gado M : Analysis of gas in vacuum lumbar disc. AJR Am J Roentgenol 128 : 1056-1057, 1977 https://doi.org/10.2214/ajr.128.6.1056
  6. Gulati AN, Weinstein ZR : Gas in the spinal canal in association with the lumbosacral vacuum phenomenon : CT findings. Neuroradiology 20 : 191-192, 1980 https://doi.org/10.1007/BF00336681
  7. Hidalgo-Ovejero AM, García-Mata S, Gozzi-Vallejo S, Izco-Cabezón T, Martínez-Morentín J, Martínez-Grande M : Intradural disc herniation and epidural gas : something more than a casual association? Spine (Phila Pa 1976) 29 : E463-E467, 2004 https://doi.org/10.1097/01.brs.0000142433.21912.0d
  8. Ilica AT, Kocaoglu M, Bulakbasi N, Kahraman S : Symptomatic epidural gas after open discectomy : CT and MR imaging findings. AJNR Am J Neuroradiol 27 : 998-999, 2006
  9. Kakitsubata Y, Theodorou SJ, Theodorou DJ, Yuko M, Ito Y, Yuki Y, et al. : Symptomatic epidural gas cyst associated with discal vacuum phenomenon. Spine (Phila Pa 1976) 34 : E784-E789, 2009 https://doi.org/10.1097/BRS.0b013e3181b35301
  10. Kaymaz M, Oztanir N, Emmez H, Ozkose Z, Paşaoglu A : Epidural air entrapment after spinal surgery. Clin Neurol Neurosurg 107 : 421-424, 2005 https://doi.org/10.1016/j.clineuro.2004.09.016
  11. Malghem J, Maldague B, Labaisse MA, Dooms G, Duprez T, Devogelaer JP, et al. : Intravertebral vacuum cleft : changes in content after supine positioning. Radiology 187 : 483-487, 1993 https://doi.org/10.1148/radiology.187.2.8475295
  12. Mortensen WW, Thorne RP, Donaldson WF 3rd : Symptomatic gas-containing disc herniation. Report of four cases. Spine (Phila Pa 1976) 16 : 190-192, 1991 https://doi.org/10.1097/00007632-199102000-00017
  13. Pak KI, Hoffman DC, Herzog RJ, Lutz GE : Percutaneous intradiscal aspiration of a lumbar vacuum disc herniation : a case report. HSS J 7 : 89-93, 2011 https://doi.org/10.1007/s11420-010-9168-x
  14. Raynor RB, Saint-Louis L : Postoperative gas bubble foot drop. A case report. Spine 24 : 299-301, 1999 https://doi.org/10.1097/00007632-199902010-00023
  15. Ricca GF, Robertson JT, Hines RS : Nerve root compression by herniated intradiscal gas. Case report. J Neurosurg 72 : 282-284, 1990 https://doi.org/10.3171/jns.1990.72.2.0282
  16. Righini A, Lucchi S, Reganati P, Zavanone M, Bettinelli A : Percutaneous treatment of gas-containing lumbar disc herniation. Report of two cases. J Neurosurg 91 (1 Suppl) : 133-136, 1999
  17. Sasani M, Ozer AF, Oktenoglu T, Cosar M, Karaarslan E, Sarioglu AC : Recurrent radiculopathy caused by epidural gas after spinal surgery : report of four cases and literature review. Spine (Phila Pa 1976) 32 : E320-E325, 2007 https://doi.org/10.1097/01.brs.0000261565.76537.ea
  18. Tsitouridis I, Sayegh FE, Papapostolou P, Chondromatidou S, Goutsaridou F, Emmanouilidou M, et al. : Disc-like herniation in association with gas collection in the spinal canal : CT evaluation. Eur J Radiol 56 : 1-4, 2005 https://doi.org/10.1016/j.ejrad.2005.04.003
  19. Wang HJ, Chen BB, Yu CW, Hsu CY, Shih TT : Alteration of disc vacuum contents during prolonged supine positioning : evaluation with MR image. Spine (Phila Pa 1976) 32 : 2610-2615, 2007 https://doi.org/10.1097/BRS.0b013e318158cb49
  20. Yoshida H, Shinomiya K, Nakai O, Kurosa Y, Yamaura I : Lumbar nerve root compression caused by lumbar intraspinal gas. Report of three cases. Spine (Phila Pa 1976) 22 : 348-351, 1997 https://doi.org/10.1097/00007632-199702010-00021

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  2. Dorsal Epidural Gas after Lumbar Microdiskectomy Treated with CT-guided Needle Aspiration vol.16, pp.2, 2020, https://doi.org/10.13004/kjnt.2020.16.e25
  3. Epidural gas-containing pseudocyst leading to lumbar radiculopathy: A case report vol.9, pp.24, 2014, https://doi.org/10.12998/wjcc.v9.i24.7279