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http://dx.doi.org/10.3340/jkns.2014.56.6.521

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)
Publication Information
Journal of Korean Neurosurgical Society / v.56, no.6, 2014 , pp. 521-526 More about this Journal
Abstract
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.
Keywords
Epidural gas; Vacuum phenomenon; Lumbar spine; Recurrent radiculopathy; Spinal surgery;
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