Last revised by Frank Gaillard on 14 Apr 2024

Pneumorrhachis refers to the presence of gas within the spinal canal (either intra- or extradural). It is rare.

Patients can often be asymptomatic 3.

Pneumorrhachis can result from a number of causes:

Patients with pneumorrhachis usually are managed conservatively. The entrapped gas occupying parts of the cerebrospinal compartment may cause syndromes of both intracranial and intraspinal hypertension, as well as hypotension as a consequence to either an increase or decrease of intracranial and intraspinal pressure 3.

Pneumorrhachis can in rare cases cause symptoms of cord compression and may even require decompressive surgery. Hence, rapid evaluation and diagnosis remain important 8.

The term pneumorrhachis derives from the Ancient Greek, πνεῦμα (pneuma) meaning air and ῥάχις (rachis) meaning spine. 

Consider intradiscal gas from degenerative disc disease 12. A posteriorly bulging disc containing gas, in particular, may appear intrathecal in location. Sagittal views are helpful in establishing location of gas.

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