La presencia de gas epidural en el canal raquídeo es un hallazgo infrecuente, relacionado con patología vértebro discal de origen degenerativo, traumático, infeccioso o tumoral.
Se presenta un caso clínico de un varón de 48 años, con historia de lumbociatalgias recidivantes, que a su ingreso presenta radiculopatía sensitiva L5 y SI derecha relacionada con una colección de gas ocupando el receso lateral L5 derecho.
El cuadro clínico se resolvió satisfactoriamente con la cirugía.
El fenómeno de vacío intradiscal se relaciona con presiones subatmosféricas, probablemente por expansión del nitrógeno y otros gases disueltos en los tejidos vecinos. Debido a la naturaleza avascular del disco este gas no se reabsorbe, pudiendo migrar al espacio epidural a través de una fisura en el anulus.
El diagnóstico de imagen no suele plantear problemas y la intervención quirúrgica está indicada cuando la clínica no se resuelve o recidiva.
Gas in the epidural space is arare event related to degenerative, traumatic, infectious or tumoral spinal disease.
We are presenting the case of a 48 year old male with a 30 year history of low back pain and episodes of right sciatica who had a sensitive L5 and SI radiculopathy related with a large gas coIlection occupying the right L5 lateral recesus. Surgical removal of gas was followed by total remission of the symptoms.
Disc vacuum phenomenon is due to intradiscal subatmospheric pressure, when gases dissolved in the tissues are released. Disc avascular nature makes difficult gas resorbtion which may extend to the epidural space throught an anulus fissure.
Diagnosis of this pathology is not difficult and surgical treatment is mandatory when the clinical symptoms persist.
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