STUDY DESIGN: This is a case report. OBJECTIVE: A case of intraspinal air in a polytraumatized patient with unrecognized pneumothorax after blunt chest trauma is reported. SUMMARY OF BACKGROUND DATA: In most cases, intraspinal air is associated with degenerative disc disease, epidural abscess, or synovial cyst, or it follows iatrogenic manipulation. Scialdone and Wagle first reported a case of intraspinal air due to a laceration of the right main bronchus. No previous case of intraspinal air after a simple unsuspected pneumothorax following blunt chest trauma has been reported. METHODS: During routine x-ray and computed tomography examination of a polytraumatized patient, an unsuspected pneumothorax due to a rib fracture was detected in a thorax computed tomography scan. Computed tomography scans of the cervical spine showed a collection of intraspinal air. RESULTS: The computed tomography examination of a polytraumatized patient with an unsuspected pneumothorax after blunt chest trauma showed the embolization of air in the paravertebral vein plexus and in the intraspinal canal. CONCLUSION: These observations suggest a wider indication for computed tomography scans of the thorax in blunt chest trauma. Also, whenever intraspinal air is found in the diagnostic course of a traumatized patient, a hidden pneumothorax should be suspected and ruled out.
STUDY DESIGN: This is a case report. OBJECTIVE: A case of intraspinal air in a polytraumatized patient with unrecognized pneumothorax after blunt chest trauma is reported. SUMMARY OF BACKGROUND DATA: In most cases, intraspinal air is associated with degenerative disc disease, epidural abscess, or synovial cyst, or it follows iatrogenic manipulation. Scialdone and Wagle first reported a case of intraspinal air due to a laceration of the right main bronchus. No previous case of intraspinal air after a simple unsuspected pneumothorax following blunt chest trauma has been reported. METHODS: During routine x-ray and computed tomography examination of a polytraumatized patient, an unsuspected pneumothorax due to a rib fracture was detected in a thorax computed tomography scan. Computed tomography scans of the cervical spine showed a collection of intraspinal air. RESULTS: The computed tomography examination of a polytraumatized patient with an unsuspected pneumothorax after blunt chest trauma showed the embolization of air in the paravertebral vein plexus and in the intraspinal canal. CONCLUSION: These observations suggest a wider indication for computed tomography scans of the thorax in blunt chest trauma. Also, whenever intraspinal air is found in the diagnostic course of a traumatized patient, a hidden pneumothorax should be suspected and ruled out.
Authors: Markus F Oertel; Marcus C Korinth; Marcus H T Reinges; Timo Krings; Sandra Terbeck; Joachim M Gilsbach Journal: Eur Spine J Date: 2006-07-12 Impact factor: 3.134