Related Experiment Video
Updated: May 4, 2026
02:14
Full Endoscopic Interlaminar Approach for Paracentral L5-S1 Disc Herniation
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Vacuum Disc Phenomenon Turned Gassy Disc Herniation: A Case Report
Esther Benedetti de Marrero1,2, Tho Chi Le1,2, Bradley Jones1,2
1Bruce W. Carter Department of Veterans Affairs Medical Center, Miami VA Healthcare System, Miami, FL.
Pain Medicine Case Reports
|July 1, 2025
Summary
The vacuum phenomenon, or gas in spinal joints, can cause back pain. This case shows successful treatment of nerve root compression from vacuum phenomenon using radiofrequency ablation.
Area of Science:
- Radiology
- Pain Medicine
- Spinal Imaging
Background:
- The vacuum phenomenon is gas accumulation in degenerated spinal structures.
- This gas can cause nerve compression, leading to pain and radiculopathy.
- Radiological findings may not correlate with clinical symptoms.
Observation:
- A 45-year-old man with lumbar facet arthropathy presented with axial low back pain.
- Imaging showed a gas-filled mass in the lateral recess compressing L5 and S1 nerve roots.
- Symptoms were exclusively axial, consistent with facet joint arthropathy.
Findings:
- The patient underwent radiofrequency ablation of the L3-L4 medial branches and L5 dorsal ramus.
- This treatment resulted in near-complete resolution of his axial low back pain.
- The vacuum phenomenon was effectively managed by targeting the affected facet joints.
Implications:
- Accurate diagnosis requires correlating imaging findings with clinical presentation.
- Radiofrequency ablation can be an effective treatment for vacuum phenomenon-induced pain.
- Careful evaluation is crucial for managing low back pain with potential non-concordant imaging findings.
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