Intervertebral disc vacuum phenomenon

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.

Epidemiology

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.

Clinical presentation

This phenomenon is asymptomatic.

Pathology

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.

Complications

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.

Differential diagnosis

• gas collection associated with a non-united vertebral fracture ⁷

See also

• vacuum phenomena
• vertebral pneumatocyst
• facet joint vacuum phenomena