title: Symptomatic gas-containing herniated disc with the vacuum phenomenon: mechanism and treatment. Case report.
abstract: A 76-year-old woman presented with an extremely rare case of symptomatic gas-containing disc herniation manifesting as left posterolateral thigh pain and ankle dorsiflexion motor weakness. The diagnosis was L3-4 vacuum disc associated with epidural pneumorrhachis. The patient underwent partial hemilaminectomy and cyst incision. After incising the cyst, the thecal sac and root were decompressed sufficiently. Vacuum disc is a common phenomenon in the elderly rarely associated with pneumorrhachis and is usually asymptomatic. Symptomatic epidural gas-containing herniated discs with the vacuum phenomenon are very rare. Gas aspiration should be considered, but excision of the gas-containing herniated disc should be performed in patients with neurological deficits, frequent recurrence, or difficult location to approach.
authors.affiliation: Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Korea.
authors.forename: Chang-Hyun
authors.initials: CH
authors.lastname: Lee
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Cho
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Hyun
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Yoon
authors.forename: Ki-Jeong
authors.initials: KJ
authors.lastname: Kim
authors.forename: Hyun-Jib
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D003560:Cysts / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005740:Gases / Q000378:metabolism*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D012585:Sciatica / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D014618:Vacuum
chemical_list: D005740:Gases