Extensive Pneumorrhachis Associated with Vaping-Induced Lung Injury

Background: Pneumorrhachis refers to air within the spinal canal and is most commonly associated with traumatic spinal injuries or spine surgery. A link between pneumorrhachis and certain pulmonary diseases, such as asthma, has also been demonstrated in the literature; however, there are no previous reports of pneumorrhachis secondary to vaping-induced lung injury. Case Description: A 15-year-old boy with vaping-induced lung injury experienced acute respiratory decompensation after straining. Computed tomography of the chest revealed bilateral pneumothoraces, extensive pneumomediastinum, and pneumorrhachis. Extensive air was seen in the spinal canal from the cervical spine down to the level of the T8 vertebrae. Conclusions: The emerging condition of vaping-induced lung injury may place patients at risk for serious complications of extrapulmonary air including pneumorrhachis. To our knowledge, this is the first report of pneumorrhachis secondary to vaping-induced lung injury.