Abstract
Pneumorrhachis, denoting intra-spinal air, is an uncommon epiphenomenon of coincident
underlying injuries and diseases, accompanied by different aetiologies and possible
pathways of air entry into the spinal canal. Air within the spinal canal can be divided
into primary and secondary pneumorrhachis, extra- or intradural pneumorrhachis and
aetiologically subsumed into iatrogenic, traumatic and nontraumatic The pathogenesis
and aetiologies of pneumorrhachis are multifold and can be a diagnostic challenge.
CT is the imaging tool of choice. Pneumorrhachis has to be differentiated from free
intraspinal gas collections and the coexistence of air and gas within the spinal canal
has to be considered differential diagnostically. Pneumorrhachis usually is asymptomatic
but can also be symptomatic by itself as well as by its underlying pathology. The
latter, although often severe, might be concealed and has to be examined carefully
to enable adequate patient treatment. The management of pneumorrhachis has to be individualized.
Keywords
pneumorrhachis - intradural - spinal canal