The Vacuum Disc Phenomenon is the presence of gas in the interverbal disc space. In other terms, we can say that the Vacuum Disc Phenomenon is the aseptic gas collection in some of the specific tissues. These gases might include nitrogen with traces of carbon dioxide and oxygen. If you want to know a bit more about what is Vacuum Disc Phenomenon then keep going through this article.
Below, we will let you know what is the Vacuum Disc Phenomenon and some other relevant information about the issue.
What is Vacuum Disc Phenomenon
As we said earlier, the Vacuum Disc Phenomenon is the collection of the gas in the intervertebral discs. However, they can sometimes also happen in the bones, different joints of the body, etc. Sometimes they are also found in adjacent locations due to migration. The occurrence frequency of the Vacuum Disc Phenomenon largely depends on the location of occurrence as well as in the involved tissues.
In most cases, the Vacuum Disc Phenomenon happens amongst the elders in the intervertebral discs. The prevalence can go up to 20% among the elders. On the other hand, the percentage in frog-leg-lateral radiographs is around 8.6% for the children. As per sources, the Vacuum Disc Phenomenon can be physiological or in the scope of the pathological process.
Based on the location, the Vacuum Disc Phenomenon can be classified in different variations. Such as the intradiscal, intra-articular, intraosseous, and some other tissues. Compared to the pathological, the physiological vacuum phenomenon can be more prevalent in the intervertebral disc with the aging process. It can also occur in some other joints which require a whole lot of wide range of movement or distractive forces.
Symptomatic Epidural Gas-containing Cyst from Intervertebral Vacuum Phenomenon
As per a journal on e-neurospine by some Korean scientists, the Vacuum Disc Phenomenon is a real thing. As per the journal, the Vacuum Disc Phenomenon is basically a collection of gas in the intervertebral disc. But interestingly this doesn’t cause nerve compression in most cases. Even if it creates, there are very low chances of this. As per their study, in some rare types of Vacuum Disc Phenomenon, the spinal canal may affect by posterior gas displacement along with epidural space.
As the author describes, they worked with two of the patients that arrives with the symptomatic gas-containing cyst. These have occurred from the Vacuum Disc Phenomenon in the intervertebral disc and caused lumbosacral radiculopathy. The radiology report has shown an intervertebral vacuum Phenomenon and gas accumulator in the lumbar epidural space. It has compressed the Dural scale as well as the nerve root.
The clinical importance of the Vacuum Phenomenon is low as it rarely causes any issue. But sometimes it can cause some different variations of the clinical pattern. Some of the patients might complain about low back pain or radicular pain. The pain occurs due to the compression of the nerve root and the Dural sac.
As per the doctors, they have experienced some unusual significance in these two patients. Which is lumbosacral radiculopathy development from the gas-containing cyst. The doctor suspects that they have been formed from the degenerative disc and then got released into the epidural space. That release happened through the teras of the annulus fibrosus.
The Cases
The first patient was an 83 year old who arrived with back and left radiating pain and was admitted to the clinic. As per the MRI report of the patient, the marked disc space was narrowing in this patient. There was low signal intensity on both of the images and they have shown consistent gas formation. The color of the gas-containing cyst was a bluish-colored sac that didn’t communicate with the disc space. And there was no evidence of the disc extrusion in neural foramen. As per the doctor, the symptom of this person was solved after the surgery and there was no complication during the follow-up period which was around 6 months.
Another case was a 72 years old female patient who arrived with pain on the left lower extremity. The pain radiated to the other places that include the buttock, some parts of the upper thigh, posterior calf. The symptom was more significant when she tried to stand and walk but become low when sitting. There was no history of lumbar puncture, surgery, epidural injection, or something like this. Moreover, there was no motor dysfunction and the straight leg-raising test was also negative.
As per the MRI report, the low signal intensity lesion was well-encapsulated and was compatible with the formation of gas and calcification. Then the patient wants through under laminectomy and left L5-S1 discectomy. Doctors observed the nerve root gas containing cyst during the surgery. They performed needle puncture on the gas-containing cyst with subtotal excision of the wall. They have seen significant improvement in the radicular symptom. After the surgery, there was no recurrence of this during the one-year follow-up period.
Outcome
The vacuum disc phenomenon radiographic finding form by the gas formation and it mostly happens in the intervertebral disc. As per the doctor’s finding, it can associate with some variation infection, trauma, and invasive procedure. The first time it was reported was during 1904 and discussed the presence of free intraspinal de-generates.
In the case of annulus fibrosus tears, the gas can release and collect through the epidural space. As we discussed above, the epidural gas is typically present in the patients but in some rare cases, this can illicit lumbosacral radiculopathy. It is happen because of the composition of gas like nitrogen, carbon dioxide, and traces of oxygen. 3 of the 79 patients of the epidural gas with spinal stenosis on CT scan images, also had the vacuum disc Phenomenon.
As per the doctor, MRI is a good way to evaluate the intervertebral disc along with spinal cord and nerve roots affected by degeneration.
Conclusion
The entire vacuum disc is a very difficult topic and it is also very complex to understand. You can read some journals on this to make things easier.
