Epidural air entrapment after spinal surgery

A case which had developed neurological complication because of compression due to air trapping in the epidural space after spinal surgery is presented with its clinical and radiological findings. Nitrous oxide can easily diffuse into the air-filled spaces in the body from the bloodstream and also increases the pressure of the air in the closed spaces. After the L4-5 discectomy procedure, weakness in dorsal flexion was occurred on the contra lateral leg. The patient was evaluated urgently with radiological examinations. Postoperative radiological findings showed air compression between L3 and L5 levels which occupied the epidural space. The surgical approach was not considered. Following the resolution of the air in the epidural space, neurological deficit was progressively improved. In order to prevent neurologic complication due to air trapping in spinal surgery, avoidance of using nitrous oxide and also irrigation of the surgical field with isotonic fluid is recommended. (c) 2004 Elsevier B.V. All rights reserved.