Postoperative intraspinal gas in lumbar disc herniation surgery: a case report and clinical review

BACKGROUND: Lumbar fenestration discectomy is a widely used surgical procedure for lumbar disc herniation (LDH), with a generally favorable safety profile. However, postoperative intraspinal gas accumulation, though rare, can cause significant significant neurological complications. CASE PRESENTATION: We report a rare case of postoperative intraspinal gas accumulation in a 59-year-old female following L5-S1 lumbar fenestration discectomy. The patient initially experienced relief from radicular symptoms post-surgery, but severe pain and recurred on postoperative day two. Imaging revealed significant intraspinal gas compressing the dural sac and nerve roots. Despite conservative management, surgical intervention was necessary to evacuate the gas and relieve the symptoms. The patient made a complete recovery, with postoperative imaging showing complete resolution of the gas accumulation. CONCLUSIONS: This case highlights the importance of early recognition and management of postoperative intraspinal gas accumulation, a rare but serious complication of lumbar discectomy. Prompt diagnosis through imaging and timely surgical intervention can lead to favorable outcomes. Awareness of this condition may improve diagnostic accuracy and patient care in similar clinical scenarios.