PMC5394855_01
Transverse computerized tomography (CT) and sagittal CT and magnetic resonance imaging images of case 1 showing the symptomatic compression of the cauda equina by a gas-containing disc protrusion (arrow) that appeared 3 years after the first surgical procedure done to remove the intervertebral disc protrusion. The vacuum phenomenon is visible on the sagittal CT image (arrow head).
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F1
A new CT scan showed that a lumbar disc protrusion with an epidural gas accumulation had formed, compressing the cauda equina from the ventral side (Figure 1).
PMC5394855_02
A preoperative computerized tomography scan of case 2 showing the bony osteochondrosis dissecans fragment (white arrows) and the gas-containing disc protrusion (black arrows) affecting the cauda equina at the L7-S1 level.
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F2
CT scan revealed a sacral osteochondrosis dissecans (OCD) lesion with a large fragment in the vertebral canal on the left side caudal of the L7-S1 IVD. Cranial of the OCD fragment, an IVD protrusion with gas inclusion could be seen in the vertebral canal on the right (Figure 2).
A postoperative computerized tomography scan of case 2 showing that the bony osteochondrosis dissecans fragment and the gas-containing disc protrusion were removed.
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F3
The OCD fragment and the disc protrusion were removed via a dorsal laminectomy L7-S1 and a partial discectomy (Figure 3).
PMC5394855_03
A computerized tomography scan of case 3 showing the gas-containing disc protrusion (black arrows) affecting the cauda equina at the L7-S1 level.
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F4
The L7-S1 IVD was protruded, and a gas-filled cystic structure within the spinal canal had developed, leading to moderate ventral compression of the cauda equina (Figure 4).