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Symptomatic Epidural Gas after Open Diskectomy: CT and MR Imaging Findings

A.T. Ilicaa, M. Kocaoglua, N. Bulakbasia and S. Kahramanb

a Department of Radiology, Gulhane Military Medical School, Ankara, Turkey
b Department of Neurosurgery, Gulhane Military Medical School, Ankara, Turkey


Figure 1
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  		Fig 1. An axial CT scan reveals posterior disk herniation containing air. Vacuum phenomenon was also noted within intervertebral disk space.


Figure 2
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  		Fig 2. A preoperative axial T1-weighted (TR, 477; TE, 14) MR image shows a herniated disk containing signal void air bubbles.


Figure 3
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  		Fig 3. Postoperative axial and sagittal MR images of lumbar spine before and after administration of intravenous contrast media and noncontrast axial CT scan.

A, An axial T1-weighted (TR, 477; TE, 14) MR image shows a signal void gas accumulation in the right anterolateral epidural space compressing the dural sac and displacing the right L5 nerve root to the posterior.

B, An axial postcontrast T1-weighted MR image at the same level with Fig 1A demonstrates granulation tissue enveloping the signal void gas.

C, A sagittal fat saturated T2-weighted (TR, 3500; TE, 120) MR image reveals the signal void gas collection at the level of L4 vertebra inferior endplate. Disk space narrowing and degeneration at the L4-L5 endplates were also observed.

D, An axial CT scan confirms the ovoid cystlike gas occupying the right lateral recess.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X