Traumatic Pediatric Pneumorachis Case Report and Review of the Literature

Study Design. Case report. Objective. To report on a case of traumatic pneumorachis in a child and to review the existing literature. Summary of Background Data. Pneumorachis, the presence of air in the spinal canal, is an extremely rare finding. It may be caused by diverse pathologies such as incidental durotomy, barotrauma, pneumothorax, and trauma. In the polytrauma patient, it may be an indication of an occult spinal fracture. Methods. The case of a 15-year old with complete paraplegia presenting with pneumorachis is presented. Results. The initial computed tomography scan showed air in the spinal canal as well as surrounding subpleural and intramuscular spaces. However, there was near normal vertebral alignment with no fractures seen. Magnetic resonance imaging taken after the patient was stabilized showed a complete transaction of the spine at T3-T4 with ligamentous injury. A posterior instrumentation and fusion was performed. Conclusion. In the pediatric patient presenting with neurologic deficits and pneumorachis, ligamentous injury of the spine, even in the absence of bony injury, should be suspected.