Intraosseous pneumatocysts of the cervical spine: a report of four cases and review of literature

Abstract

Pneumatocysts are benign, gas-containing lesions, most commonly observed affecting the vertebrae, sacrum, and ileum. Most often, these lesions are asymptomatic and are detected incidentally during imaging examinations. Although once believed to be a rare lesion, recent studies suggest that it is more common than previously thought. We present four cases of pneumatocysts affecting the cervical vertebrae detected as incidental findings on cone beam computed tomography (CBCT). Given the increased use of CBCT in dentistry to evaluate the maxillofacial structures, it is likely that dentists will encounter this lesion on CBCT scans that encompass the superior cervical spine. Recognition of the pathognomonic features of this benign, innocuous lesion is important to avoid unnecessary investigations and causing alarm to the patient. We also present a comprehensive review of the literature on the demographic characteristics and clinical presentation of this relatively unknown lesion.

Pneumatocysts in Elderly Adults: A Black Hole in Neck Pain

“…A history of previous episodes of neck pain (caused by the pneumatocyst) was not collected in these subjects. For the same reason, symptomatic pneumatocysts of the cervical spine are considered to be uncommon, with only 25 cases reported in the English literature to the knowledge of the authors of the current letter, although a recent retrospective study suggests that they are more common than previously believed …”

“…It is an intraosseous gas collection of particular interest for geriatricians because its prevalence increases in individuals aged 60 and older, and it is occasionally described in imaging reports in individuals with neck pain. The etiology of pneumatocysts is uncertain . Some reports have suggested that gas in the adjacent intravertebral disc extends into the vertebral body because of degenerative erosion of the vertebral endplate.…”

“…Some authors have described progression of the lesion in size, whereas others have documented stable lesions on serial imaging . Sometimes, the lesions become large enough to occupy most of the vertebral body, and vertebral fracture may be a concern …”

“…Pneumatocysts may be the reason for elderly adults complaining of neck pain, and conservative therapy is usually sufficient to alleviate symptoms. Given the possibility of enlargement of the lesions—with a risk of fracture—and the need to exclude other aggressive disorders, follow‐up radiographic examination should be considered.…”

Multiple intraosseous cervical pneumatocysts: A case report of a rare incidental finding on cone-beam computed tomography

“…It is more likely that dentists will encounter pneumatocyst-like lesions in the cervical spine while interpreting diagnostic radiographs. 8 Medium and large fields of view are the image volumes that enable diagnosticians to identify incidental findings of the cervical spine on CBCT. 8 …”