Symptomatic Epidural Gas-containing Cyst from Intervertebral Vacuum Phenomenon

Abstract

Vacuum disc phenomenon is a collection of gas in the intervertebral disc space but rarely causes nerve compression. However, some rare type of vacuum phenomenon in the spinal canal may bring about posterior gas displacement within the epidural space. The authors describe two patients with symptomatic epidural gas-containing cyst that seem to be originating from vacuum phenomenon in the intervertebral disc, causing lumbosacral radiculopathy. Radiographic studies demonstrated intervertebral vacuum phenomenon and accumulation of gas in the lumbar epidural space compressing the dural sac and the nerve root. The nerve root in both patients was compressed by gas containing cyst that was surrounded by thin walled capsule separable from the gaseous degenerated disc space. The speculative mechanism of the nerve root compression is discussed. The possibility of gas containing cyst should be considered in case of the nerve root compression in which epidural gas is present.

Epidural Pneumatic Pseudocyst with Lumbar Radiculopathy: Two Case Reports and Review of the Literature

“…The location of lesion was appeared in various areas of the lumbar spine. We classified the lesion into locations of level and compression type in previous studies including our cases [1][2][3][4][6][7][8][9][10][11][12][13][14][15] . The compression to neural tissues type was divided into three types: canal (central to paracentral), foraminal and extraforaminal.…”

Epidural Gas Accumulation in Connection with Canine Degenerative Lumbosacral Disease

“…CT scans not only show that the mass within the spinal canal is partially composed of gas but also provide useful information about the condition of the disc and the rest of the lumbar spine. Surgery is recommended and generally successful in human patients who fail to respond to conservative therapy for gas-containing lumbar disc herniations (18–21, 33–35). The two canine patients treated by surgical removal of the causes of the lumbosacral stenosis, including the epidural gas accumulation, improved after the procedure and rehabilitation.…”

Nerve root compression caused by intraspinal gas accumulation. A case report

“…Epi du ri nia me tar pe du jø in tar pai ið plin ta á ke lis stu bu ro ly gius ar ba for muo ja vie nà pseu do cis tà, ku ri ga li tu rë ti jun gia mo jo au di nio kap su lae [8,12,13]. Du jø san kau pa taip pat ga li bû ti ran da ma ir tarps lanks te li nio dis ko ið varþos frag men te [14].…”

“…Skaus mo ar neu ro lo gi niø simp to mø truk më ga li bû ti ávai ri: re mian tis at ve jø ap ra ðy mais, lai kas nuo simp to mø at si ra di mo iki diag no zës nu sta ty mo bu vo nuo 1 mën. iki 3 me tø [8,11,13].…”

“…Ge riau siai VF vi zu a li zuo jan tis ra dio lo gi nis ty ri mo me to das yra kom piu te ri në to mog ra fija. Esant ðiai pa to lo gi jai, KT vaiz duo se ma to mi ávai raus dy dþio hi po den si niai in tar pai [1,13,18]. KT ty ri mø me tu VF nu sta to mas net 25-46 % at ve jø [4,5].…”