Pneumorrhachis, Pneumothorax, and Subcutaneous Emphysema
A 65-year-old man was admitted to the hospital to undergo adjuvant radiotherapy after having previously undergone tumor mass reduction and anterior and posterior stabilizing spinal surgery for a synovial sarcoma. On physical examination, ballooning of the right paravertebral area was noted, which increased when the Valsalva maneuver was performed...

http://www.nejm.org/doi/full/10.1056/NEJMicm1506684
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