Lumbar radicular compression due to epidural gas

Gas in the epidural space is a rare event related to degenerative, traumatic, infectious or tumoral spinal disease. We are presenting the case of a 48 year old male with a 30 Bear history of low back pain and episodes of right sciatica who had a sensitive L5 and S1 radiculopathy related with a large gas collection occupying the right L5 lateral recesus. Surgical removal of gas was followed by total remission of the symptoms. Disc vacuum phenomenon is due to intradiscal subatmospheric pressure, when gases dissolved in the tissues are released. Disc avascular nature makes difficult gas resorbtion which may extend to the epidural space throught an anulus fissure. Diagnosis of this pathology is not difficult and surgical treatment is mandatory when the clinical symptoms persist.