J Korean Soc Spine Surg.  2001 Mar;8(1):81-85.

Intraspinal Gas with Lumberjack Injury: A Case Report

• Shin BJ
• Yun TK
• Kang HS
• Lee JC
• Kim KJ
• Kim YI

Abstract

STUDY DESIGN: A case report and review of the literature.
OBJECTIVE
To discuss the intraspinal gas associated with lumberjack injury and review the literature. MATERIAL AND METHOD: A 60-year-old man developed chest pain & paraplegia by fall down from 4m height, having hypoes-thesia on T7-8 dermatome and complete motor-sensory loss below T9.
RESULTS
Multiple rib fractures and hemopneumothorax were observed on chest radiograph and only mild offset was noted on plain spine lateral radiograph. CT scan reveals multiple air bubbles around epidural space at T7-8 and fracture of T7 pedicle. MRI shows rupture of both anterior and posterior longitudinal ligaments and extruded intervertebral disc of T7-8. Posterior decompression and stabilization with posterolateral fusion was performed on T5-9, but pain was persisted and paralysis was not improved after surgery. SUMMARY: The intraspinal gas of this case is supposed to be made by air migration from pleural cavity to intraspinal canal because of severe soft tissue injuries and fistula formation. Immediate and precise diagnosis with operative treatment was con-sidered to be important.

Keyword

Thoracolumbar; Intraspinal gas; Lumberjack

MeSH Terms

Chest Pain
Decompression
Diagnosis
Epidural Space
Fistula
Hemopneumothorax
Humans
Intervertebral Disc
Longitudinal Ligaments
Magnetic Resonance Imaging
Middle Aged
Paralysis
Paraplegia
Pleural Cavity
Radiography, Thoracic
Rib Fractures
Rupture
Soft Tissue Injuries
Spine
Tomography, X-Ray Computed

Figure

• 

  Fig. 1-A. The thoracolumbar anterioposterior radiograph shows no specific finding. B. The thoracolumbar lateral radiograph shows minimal offset(white arrow head) of vertebral body border at the level of T7-8.

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  Fig. 2. CT scan of the thoracic spine shows an air bubble in epidural space(white arrow head) adjacent to the fracture line between vertebral body and pedicle.

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  Fig. 3. MRI showing extrusion of intervertebral disc combined with rupture of both anterior and posterior longitudinal ligament.

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  Fig. 4-A, B. Posterior stabilization with pedicle screw system and posterior fusion of T5-9 was performed.

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