Dura sac compression due to spinal epidural gas pseudocyst after lumbar decompression surgery: a case report

BMC Musculoskelet Disord. 2019 Jun 21;20(1):296. doi: 10.1186/s12891-019-2682-1.

Abstract

Background: Intraspinal gas pseudocyst is rare, especially following spinal surgery. Here we present a case of spinal epidural gas pseudocyst following lumbar decompression surgery, which caused dura sac compression.

Case presentation: A 52-years-old woman with chronic lumbar pain and radiating numbness of left leg was admitted to our hospital and underwent a posterior lumbar decompression surgery. 10 days later, the patient began to have dysfunction of excretion. CT and MRI were taken and epidural gas was detected, which compressed the dura sac. A huge pseudocyst encapsulated with high-tension air was found during debridement with no evidence of infection.

Results: Debridement surgery was taken to remove the encapsulated gas and cyst wall and her symptoms disappeared soon after the surgery. 2 weeks later, routine X-ray was repeated and gas pseudocyst disappeared with no signs of infection.

Conclusion: Gas pseudocyst in the spinal canal is rare, especially after lumbar surgery and causing spinal cord compression. CT and MRI can be used to detect the spinal gas. Once gas pseudocyst causes dura sac compression, proper methods should be chosen to treat this kind of intraspinal gas pseudocyst.

Keywords: Dura sac compression; Gas pseudocyst; Lumbar surgery.

Publication types

  • Case Reports

MeSH terms

  • Cysts / diagnosis*
  • Cysts / etiology
  • Cysts / surgery
  • Debridement
  • Decompression, Surgical / adverse effects*
  • Decompression, Surgical / instrumentation
  • Dura Mater / diagnostic imaging
  • Dura Mater / pathology*
  • Dura Mater / surgery
  • Epidural Space / diagnostic imaging
  • Epidural Space / pathology
  • Epidural Space / surgery
  • Female
  • Gases
  • Humans
  • Low Back Pain / surgery
  • Lumbar Vertebrae
  • Magnetic Resonance Imaging
  • Middle Aged
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Spinal Cord Compression / surgery
  • Spinal Fusion / adverse effects*
  • Spinal Fusion / instrumentation

Substances

  • Gases