LUMBAR NERVE ROOT COMPRESSION CAUSED BY LUMBAR INTRASPINAL GAS - REPORT OF 3 CASES

Study Design. Three cases of lumbar nerve root compression associated with intradiscal gas formation and its migration are reported. Objecti ves. To establish the pathogenic mechanism by which gas is formed in t he spinal canal. Summary of Background Data. Few such cases have been reported of patients with clinical symptoms of lumbar radiculopathy re sulting from gas in the spinal canal. Methods. Surgery with needle asp iration of the gas was performed in all cases.Results. The presence of the gas was detected in the extradural space in one patient and withi n the nerve sheath in two patients. After surgery, all patients recove red well, and there were no obvious remnant neurologic abnormalities. One year later, all patients were completely free of symptoms. Conclus ions. Surgery with needle aspiration of the gas resulted in clinical i mprovement in all cases, confirming that intraspinal gas is an importa nt cause of lumbar radiculopathy. The composition of the gas in one pa tient was analyzed by gas chromatography, which revealed an overwhelmi ng preponderance of nitrogen. A relationship between a gas-containing pseudocyst in the spinal canal and a degenerated intervertebral disc w as identified, a key finding for understanding the precise nature of t his disorder. Intradiscal gas formation and its outward migration as a sequel of intervertebral disc degeneration also has been addressed in this report.