Intra-discal vacuum phenomenon with advanced lumbar spine disc degeneration: complementary findings from both MRI and CT
Abstract Objective Intra-Discal Vacuum phenomenon (IDVP) is associated with advanced disc degeneration, representing persistent intra-segmental movement. Our objective is to further characterise IDVP patterns from both MRI and CT thus informing on an otherwise poorly understood phenomenon. Methods A...
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BMC
2025-03-01
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| Series: | BMC Medical Imaging |
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| Online Access: | https://doi.org/10.1186/s12880-025-01635-y |
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| author | Derek T. Cawley Aoibhín McDonnell Andrew Simpkin Thomas Doyle Mohammed Habash Conor McNamee Cliona Nic Gabhann Padraig O’Reilly David O’Sullivan Robert Woods Aiden Devitt |
| author_facet | Derek T. Cawley Aoibhín McDonnell Andrew Simpkin Thomas Doyle Mohammed Habash Conor McNamee Cliona Nic Gabhann Padraig O’Reilly David O’Sullivan Robert Woods Aiden Devitt |
| author_sort | Derek T. Cawley |
| collection | DOAJ |
| description | Abstract Objective Intra-Discal Vacuum phenomenon (IDVP) is associated with advanced disc degeneration, representing persistent intra-segmental movement. Our objective is to further characterise IDVP patterns from both MRI and CT thus informing on an otherwise poorly understood phenomenon. Methods An observational analysis was performed, including an over-60s population sample of 325 lumbar discs in 65 subjects (29 M, 36 F) with low back pain +/- leg symptoms, with MRI of the lumbar spine and concomitant CT abdomen. Exclusion criteria were those with insufficient quality, non-degenerative or destructive spinal pathology, previous neuromodulation or spine instrumentation. Results 49 subjects (94 levels) displayed IDVP, including 11/184 Pfirrmann grade 3/IVDP positive, 49/79 grade 4/IVDP positive and 34/39 grade 5/IVDP positive discs. Increased severity of IDVP significantly correlated with increased Pfirrmann grade and decreased disc height (p <.05). Affected IDVP levels within the L1L2 & L2L3 region when compared to the L4L5 & L5S1 region, displayed similar Pfirrmann grade (4.1 v 4.3) and disc height (0.52 v 0.51) but with greater severity of IDVP in the latter (1.5 v 1.98, p <.002). While 83/105 (81%) of levels with Pfirrmann 4/5 with reduced disc height, displayed IDVP, a small minority did not, where instead they displayed a significantly higher risk of adjacent IDVP (p <.05). Conclusion CT and MRI complement each other through the identification of IDVP, allowing the diagnostician further insight on disc degeneration. Worsening severity of IDVP on CT correlates with increased disc degeneration and reduced disc height on MRI, particularly in the lower lumbar spine. A small minority of advanced degenerate discs do not display IDVP and quiesce, mostly where there is presence of an adjacent IDVP. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-02c8f85f7d7545019bae2a0f9d343fe3 |
| institution | OA Journals |
| issn | 1471-2342 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Imaging |
| spelling | doaj-art-02c8f85f7d7545019bae2a0f9d343fe32025-08-20T01:48:29ZengBMCBMC Medical Imaging1471-23422025-03-012511710.1186/s12880-025-01635-yIntra-discal vacuum phenomenon with advanced lumbar spine disc degeneration: complementary findings from both MRI and CTDerek T. Cawley0Aoibhín McDonnell1Andrew Simpkin2Thomas Doyle3Mohammed Habash4Conor McNamee5Cliona Nic Gabhann6Padraig O’Reilly7David O’Sullivan8Robert Woods9Aiden Devitt10Mater Private HospitalUniversity of GalwayUniversity of GalwayUniversity of GalwayUniversity of GalwayUniversity of GalwayUniversity of GalwayUniversity of GalwayUniversity of GalwayUniversity of GalwayUniversity of GalwayAbstract Objective Intra-Discal Vacuum phenomenon (IDVP) is associated with advanced disc degeneration, representing persistent intra-segmental movement. Our objective is to further characterise IDVP patterns from both MRI and CT thus informing on an otherwise poorly understood phenomenon. Methods An observational analysis was performed, including an over-60s population sample of 325 lumbar discs in 65 subjects (29 M, 36 F) with low back pain +/- leg symptoms, with MRI of the lumbar spine and concomitant CT abdomen. Exclusion criteria were those with insufficient quality, non-degenerative or destructive spinal pathology, previous neuromodulation or spine instrumentation. Results 49 subjects (94 levels) displayed IDVP, including 11/184 Pfirrmann grade 3/IVDP positive, 49/79 grade 4/IVDP positive and 34/39 grade 5/IVDP positive discs. Increased severity of IDVP significantly correlated with increased Pfirrmann grade and decreased disc height (p <.05). Affected IDVP levels within the L1L2 & L2L3 region when compared to the L4L5 & L5S1 region, displayed similar Pfirrmann grade (4.1 v 4.3) and disc height (0.52 v 0.51) but with greater severity of IDVP in the latter (1.5 v 1.98, p <.002). While 83/105 (81%) of levels with Pfirrmann 4/5 with reduced disc height, displayed IDVP, a small minority did not, where instead they displayed a significantly higher risk of adjacent IDVP (p <.05). Conclusion CT and MRI complement each other through the identification of IDVP, allowing the diagnostician further insight on disc degeneration. Worsening severity of IDVP on CT correlates with increased disc degeneration and reduced disc height on MRI, particularly in the lower lumbar spine. A small minority of advanced degenerate discs do not display IDVP and quiesce, mostly where there is presence of an adjacent IDVP. Clinical trial number Not applicable.https://doi.org/10.1186/s12880-025-01635-yLow Back PainVacuumDisc degenerationCTMRI |
| spellingShingle | Derek T. Cawley Aoibhín McDonnell Andrew Simpkin Thomas Doyle Mohammed Habash Conor McNamee Cliona Nic Gabhann Padraig O’Reilly David O’Sullivan Robert Woods Aiden Devitt Intra-discal vacuum phenomenon with advanced lumbar spine disc degeneration: complementary findings from both MRI and CT BMC Medical Imaging Low Back Pain Vacuum Disc degeneration CT MRI |
| title | Intra-discal vacuum phenomenon with advanced lumbar spine disc degeneration: complementary findings from both MRI and CT |
| title_full | Intra-discal vacuum phenomenon with advanced lumbar spine disc degeneration: complementary findings from both MRI and CT |
| title_fullStr | Intra-discal vacuum phenomenon with advanced lumbar spine disc degeneration: complementary findings from both MRI and CT |
| title_full_unstemmed | Intra-discal vacuum phenomenon with advanced lumbar spine disc degeneration: complementary findings from both MRI and CT |
| title_short | Intra-discal vacuum phenomenon with advanced lumbar spine disc degeneration: complementary findings from both MRI and CT |
| title_sort | intra discal vacuum phenomenon with advanced lumbar spine disc degeneration complementary findings from both mri and ct |
| topic | Low Back Pain Vacuum Disc degeneration CT MRI |
| url | https://doi.org/10.1186/s12880-025-01635-y |
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