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The Journal of Bone and Joint Surgery 79:591-3 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Gas in the Spinal Canal Associated with Injury of the Cervical Spinal Cord: a Diagnostic Dilemma. A Case Report*

DAVID J. ABRAHAM, M.D.{dagger}, ALEXANDER R. VACCARO, M.D.{dagger}, TODD J. ALBERT, M.D.{dagger} and JEROME M. COTLER, M.D.{ddagger}, PHILADELPHIA, PENNSYLVANIA

Investigation performed at the Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia


   Introduction
 
A patient was seen at our institution because of quadriparesis that had developed after a fall. Confusion with regard to the diagnosis occurred when a non-enhanced computerized axial tomography scan revealed a collection of gas centrally within the cervical spinal canal. Only after magnetic resonance imaging of the cervical spine was it apparent that the gas within the canal was enclosed by a large extruded herniated disc.

A collection of gas within a desiccated nucleus pulposus is termed a vacuum disc. Evidence of gas within an intervertebral disc and within the spinal canal has been described in both cervical and lumbar spines affected by a degenerative disorder3-5,10. Although a vacuum disc in the cervical or lumbar spine is not uncommon, its relationship to an intraspinal herniated disc may be overlooked if a disc fragment has not been noted on radiographic or computerized axial tomography studies.


   Case Report
 
A fifty-seven-year-old man was . . . [Full Text of this Article]


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