Abstract
Pneumorrhachis, denoting intra-spinal air, is an uncommon epiphenomenon of coincident underlying injuries and diseases, accompanied by different aetiologies and possible pathways of air entry into the spinal canal. Air within the spinal canal can be divided into primary and secondary pneumorrhachis, extra- or intradural pneumorrhachis and aetiologically subsumed into iatrogenic, traumatic and nontraumatic The pathogenesis and aetiologies of pneumorrhachis are multifold and can be a diagnostic challenge. CT is the imaging tool of choice. Pneumorrhachis has to be differentiated from free intraspinal gas collections and the coexistence of air and gas within the spinal canal has to be considered differential diagnostically. Pneumorrhachis usually is asymptomatic but can also be symptomatic by itself as well as by its underlying pathology. The latter, although often severe, might be concealed and has to be examined carefully to enable adequate patient treatment. The management of pneumorrhachis has to be individualized.

Keywords
pneumorrhachis, intradural, spinal canal