A randomised comparison of a foot pump and low-molecular-weight heparin in the prevention of deep-vein thrombosis after total knee replacement.
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Biomedical subjects
Publications and source records attributed to S Garcia-Mata.
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STUDY DESIGN: A case report of a patient suffering from an intradural herniated disc associated with the presence of epidural gas. OBJECTIVE: To advise spine surgeons of the possible association of intradural disc herniation and epidural gas, to prevent overlooking intradural disc fragments during surgery. SUMMARY OF BACKGROUND DATA: Three cases of this rare association were published previously, something surprising given the relatively rare occurrence of intradural herniations and the presence of epidural gas. METHODS: A case is presented where such an association occurred, on the basis of preoperative examinations and intraoperative findings. The literature is reviewed for cases of herniated discs associated with epidural gas and for intradural herniations. RESULTS: During the open discectomy, after a negative epidural examination, an intradural examination was performed, revealing a disc herniation, which was removed. The patient's postoperative development was satisfactory. CONCLUSION: The possibility of an intradural herniated disc must always be considered when performing an open discectomy on a patient whose computed tomography scan reveals the presence of epidural gas. In the event that no clear disc herniation is found to justify the clinical symptoms or the previous radiologic findings, an intradural exploration may be indicated.
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SUMMARY OF BACKGROUND DATA: Intradiscal gas is associated with tumors, infection, trauma, therapeutic and diagnostic spinal procedures, deposit illnesses, and disc degeneration. The existence of gas within the spinal canal has been seen on 17 occasions, of which 13 were associated with discal hernias. METHODS: In this study, 19 additional patients with intraspinal gas corresponding to discal hernias are presented, six of whom required surgical treatment. The association of intraspinal gas with intradural hernias frequently is reported in the literature, although this has not been proven in our group. Intrahernial gas is associated with patients who have chronic problems and with advanced age. CONCLUSION: Intrahernial gas is much more common than is indicated in the literature. This finding often goes unnoticed, and the association between intradiscal gas and intradural hernias should be kept in mind.