A rare case of spontaneous giant pneumorrachis presenting with cauda equina syndrome: a case report

Pneumorrachis is a condition where air is present in the spinal canal. It can occur due to trauma, medical procedures, or spontaneously. This case report describes a rare instance of spontaneous pneumorrachis causing cauda equina syndrome. A 56-year-old male presented with difficulty walking, urinary dribbling, and back pain. Imaging revealed large air pockets in his spinal canal. He underwent surgery to relieve the pressure, and his walking improved, though bladder control did not fully recover. Pneumorrachis is often asymptomatic and found incidentally. Symptomatic cases can be managed conservatively, but those with neurological deficits may need surgery. This case is unique as it presents with cauda equina syndrome due to spontaneous pneumorrachis.

• 1
  The patient presented with cauda equina syndrome symptoms including difficulty walking, urinary dribbling, reduced perianal sensation, and absent voluntary anal contraction.
• 2
  Imaging revealed giant air pockets in the spinal canal at L5-S1 extending to L4-L5, leading to the diagnosis of spontaneous giant pneumorrachis.
• 3
  Surgical decompression via laminectomy resulted in improved motor function in the lower limbs, although bladder function did not fully recover, requiring continued clean intermittent catheterization.