AI Summary
A 71-year-old woman developed paralysis and loss of reflexes after knee surgery. MRI showed air in the spine, causing narrowing and clumping of nerves. Treatment in a hyperbaric chamber resolved the condition.
A 71-year-old woman presented with paraplegia, absent deep tendon reflexes, and a T10 sensory level 9 hours after knee replacement surgery performed under spinal anesthesia. MRI of the spine revealed intradural and extradural gas, termed pneumorrhachis (Figure, A). Air in the extradural and intradural spaces led to canal stenosis (Figure, B) and root clumping (Figure, C), respectively. The patient was immediately started on high-flow oxygen and then transferred for treatment in a hyperbaric chamber. Neurologic deficits resolved, and a CT scan (Figure, D) revealed redistribution of the gas.