CT Demonstration of Spinal Epidural Emphysema after Strenuous Exercise

Pneumorrhachis: a Rare Finding on Computed Tomography scans

“…Air has also been noted in the epidural space secondary to degenerative disc disease and epidural abscess. Pneumorrhachis can also be complicated by marijuana smoking [5], mechanical artificial ventilation and chest tube placement [6], it can be spontaneous [7,8] or can also develop after strenuous exercise [9]. Finally pneumorrhachis can develop secondary to a subarachnoid pleural fistula [10].…”

“…Thus any cause of pneumomediastinum may also result in pneumorrhachis [4,8] as in asthma, a complication of intubation or ventilation, retching or coughing and even vigorous exercise [9] Pathogenesis of Pneumorrhachis Macintosh and Mushin [12] demonstrated that the epidural space is not a closed cavity but is continuous with the paravertebral space via the intervertebral foramina. On inspiration the thoracic walls expand and the resultant negative pressure within the cage is transmitted via the paravertebral space to the epidural space.…”

Spontaneous cervicothoracolumbar pneumorrhachis, pneumomediastinum and pneumoperitoneum

“…Valsalva manoeuvre (expiration through resistance) that occurs with straining (e.g. during labour or exercise) (26), violent coughing (27) or vomiting (22) may also cause barotrauma. Cases of pneumomediastinum and pneumorrhachis in diabetic ketoacidosis, likely due to severe vomiting, have been reported (23).…”

Airlessness in Airspace. Simultaneous Occurrence of Spontaneous Pneumothorax with Pneumomediastinum and Pneumorrhachis: Report of a Case

“…[1][2][3][4][5][6][7] There have been a few published case reports and case series of spontaneous pneumothorax/pneumomediastinum in air force pilots, during basic training which involved the Valsalva maneuver and sudden high-pressure decompression. In most instances the pilots were not fl ying but were on the ground.…”