Q: 28 year old male is admitted with headache and back pain after a fall. Neurologist was called in ER who ordered CT of head and spine. ER physician called you admit patient for observation with diagnosis of pneumorrhachis. What is pneumorrhachis?

Answer: Pneumorrhachis means the presence of intraspinal air. It usually reabsorbs spontaneously and patients usually are managed conservatively but entrapped air may cause syndromes of intracranial and intraspinal hypertension. Clinical significance lies in finding potentially associated hidden and life threatening injuries. See below posterior epidural pneumorrhachisvwith pneumomediastinum.