Vacuum phenomena involving the intervertebral discs is usually a result of an accumulation of gas, principally nitrogen, within the crevices of the intervertebral discs or adjacent vertebrae.
It is a relatively common occurrence which can be observed in 1-3% of spinal radiographs and may even reach a prevalence of 20% in elderly individuals 5.
This phenomenon is asymptomatic.
This commonly occurs in association with intervertebral disc degenerative disease.
However, the presence of gas does not categorically imply merely degenerative disc disease, as other processes can lead to discs containing gas. Examples of other conditions with gas include:
- vertebral osteomyelitis
- Schmorl node formation
- spondylosis deformans
- all causes of vertebral body collapse, e.g. osteonecrosis (Kümmell disease) 2
Treatment and prognosis
No management is generally necessary.
There are occasional reports of nerve root compression associated with herniated intradiscal gas, known as pneumatic nerve root compression 6.
History and etymology
Magnusson first described it in 1937 5.
- gas collection associated with a non-united vertebral fracture 7
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- 2. Lafforgue PF, Chagnaud CJ, Daver LM et-al. Intervertebral disk vacuum phenomenon secondary to vertebral collapse: prevalence and significance. Radiology. 1994;193 (3): 853-8. Radiology (abstract) - Pubmed citation
- 3. Feng SW, Chang MC, Wu HT et-al. Are intravertebral vacuum phenomena benign lesions?. Eur Spine J. 2011;20 (8): 1341-8. Eur Spine J (full text) - doi:10.1007/s00586-011-1789-3 - Free text at pubmed - Pubmed citation
- 4. Hamzé B, Leaute F, Wybier M et-al. [Vertebral vacuum phenomena]. Ann Radiol (Paris). 1996;38 (4): 186-91. Pubmed citation
- 5. D'Anastasi M, Birkenmaier C, Schmidt GP et-al. Correlation between vacuum phenomenon on CT and fluid on MRI in degenerative disks. AJR Am J Roentgenol. 2011;197 (5): 1182-9. doi:10.2214/AJR.10.6359 - Pubmed citation
- 6. Ricca GF, Robertson JT, Hines RS. Nerve root compression by herniated intradiscal gas. Case report. (1990) Journal of neurosurgery. 72 (2): 282-4. doi:10.3171/jns.1990.72.2.0282 - Pubmed
- 7. Bernard Stallenberg, Afarine Madani, Franz Burny, Pierre Alain Gevenois. The Vacuum Phenomenon. (2012) American Journal of Roentgenology. 176 (5): 1161-4. doi:10.2214/ajr.176.5.1761161 - Pubmed
- 8. Balkissoon AR. Radiologic interpretation of vacuum phenomena. (1996) Critical reviews in diagnostic imaging. 37 (5): 435-60. Pubmed