Sciatica due to lumbar intraspinal gas pseudocyst

Percutaneous transforaminal endoscopic treatment of gas-containing pseudocyst compressing the L5 nerve root: A case report

BACKGROUND

Gas-containing pseudocysts rarely cause of lumbar radiculopathy. This report describes successful treatment of a gas-containing pseudocyst using percutaneous transforaminal endoscopy.

CASE SUMMARY

A 48-year-old man presented with severe pain and numbness in his right leg, which worsened upon walking or weight bearing. Computed tomography and magnetic resonance imaging revealed a gas-containing cyst compressing the left L5 nerve root at the L4-5 level. The pseudocyst was successfully removed using a percutaneous transforaminal endoscopic discectomy. Vivid and clear endoscopic imaging of the pseudocysts was performed intraoperatively. The patient experienced immediate pain relief and was discharged one day after the operation. The patient returned to work. Moreover, numbness in the right leg returned to normal within 6 months. At the one-year follow-up, there was no symptoms recurrence.

CONCLUSION

Transforaminal endoscopy offers excellent surgical visualization and facilitates meticulous operative manipulation, making it a minimally invasive approach for treating gas-containing pseudocysts in the intervertebral foramen.

Lumbar Radiculopathy Caused by Epidural Gas Collection

Background. Degenerated intervertebral discs in the lumbar spine are commonly found with vacuum phenomenon. In a few cases, gas can migrate into the lumbar spinal canal and compress the nerve root. Case Presentation. We report a case of lumbar radiculopathy caused by epidural gas collection in a 59-year-old woman. Originally, the gas was formed in the intervertebral disc and possibly migrated backward because of the motion of lumbar spine, forming a single large gas formation. The nerve root was freed from the gas-filled cyst after needle puncture was performed. Patient’s symptoms in the leg were significantly relieved following surgery. Conclusion. There is still no satisfactory explanation for the pathogenesis of gas formation in the spinal canal. In our case, the presence of gas in the spinal canal and gas inside a narrowed disc suggests a communication between the two structures.

Radiculopathies caused by spontaneous pneumorrachis: Two case reports and review of literature

Pneumorarchis is a rare condition of low back pain. It is usually asymptomatic and secondary to trauma. Spontaneous pneumorrachis is scarce.

Surgical Treatment of Extra-Foraminal Gas Containing Pseudocyst Compressing L5 Nerve Root by Using Unilateral Biportal Endosopy: A Case Report

BACKGOUND

Most gaseous lumbar pseudocysts have been previously reported to be located in the spinal canal and successfully treated by several therapeutic methods. By comparison, a gas containing pseudocyst in lumbar extra-foraminal area is very rare. Here, the authors report a case of symptomatic gas containing cyst located in lumbar foramen. It was successfully treated with unilateral biportal endoscopic (UBE) surgery.

CASE DESCRIPTION

a 75-year-old man presented with severe left leg pain and tingling sensation refractory to conservative treatment that aggravated with weight bearing and position change. Computed tomography and magnetic resonance imaging showed a gas containing cyst compressing the left L5 nerve root ganglion in the foramina area at L5-S1 level. Gaseous extra-foraminal pseudocyst was successfully removed by UBE surgery via para-spinal approach. Vivid and clear endoscopic operative imaging of pseudocyst in detail was obtained during operation. The patient's symptom was significantly improved after the operation.

CONCLUSIONS

Gas containing pseudocyst in lumbar foraminal area is not common. Combined use of pre-operative MRI and CT can help diagnose gaseous pseudocyst and differentiate other pathologies. UBE technique which provides good operative visualization and delicate operative manipulation is a less invasive therapeutic method to treat foraminal gas containing pseudocyst.