Imaging features and percutaneous endoscopic interlaminar decompression of vacuum disc phenomenon-induced lumbosacral radiculopathy: case report

The vacuum disc phenomenon (VDP), characterized by gas accumulation within degenerated intervertebral discs, is a radiographic hallmark of advanced spinal degeneration. Although this phenomenon is rare, VDP may also rarely present as radiculopathy due to the compression of nerve structures by dynami...

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Main Authors: Longxiao Wu, Saifei Meng, Peng Li, Chunlei Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1595166/full
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author Longxiao Wu
Saifei Meng
Peng Li
Chunlei Liu
author_facet Longxiao Wu
Saifei Meng
Peng Li
Chunlei Liu
author_sort Longxiao Wu
collection DOAJ
description The vacuum disc phenomenon (VDP), characterized by gas accumulation within degenerated intervertebral discs, is a radiographic hallmark of advanced spinal degeneration. Although this phenomenon is rare, VDP may also rarely present as radiculopathy due to the compression of nerve structures by dynamic gas migration—which is different from typical intervertebral disc protrusion. This phenomenon predominantly affects elderly populations, with computed tomography (CT) imaging serving as the gold standard for detecting hypodense gas pockets and delineating their spatial relationship to nerve roots. Unlike mechanical compression from disc fragments, gas-induced symptoms are uniquely refractory to conservative therapies, necessitating targeted surgical strategies. This report details a 72-year-old female with acute L5 radiculopathy secondary to multilevel VDP, where percutaneous endoscopic interlaminar decompression achieved immediate symptom resolution through precise gas evacuation. The case underscores the critical interplay between imaging interpretation and minimally invasive intervention in addressing this rare yet debilitating complication of spinal degeneration, while advocating for standardized protocols to optimize patient selection and outcomes.
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spelling doaj-art-2410bb19c7ec487fa3df5d0a854fb81d2025-08-20T03:50:59ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-07-011210.3389/fsurg.2025.15951661595166Imaging features and percutaneous endoscopic interlaminar decompression of vacuum disc phenomenon-induced lumbosacral radiculopathy: case reportLongxiao Wu0Saifei Meng1Peng Li2Chunlei Liu3epartment of Spinal Surgery, Qingyuan Hospital Affiliated to Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong, Chinaepartment of Spinal Surgery, Qingyuan Hospital Affiliated to Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong, Chinaepartment of Spinal Surgery, Qingyuan Hospital Affiliated to Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong, Chinaepartment of Spinal Surgery, Qingyuan Hospital Affiliated to Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong, ChinaThe vacuum disc phenomenon (VDP), characterized by gas accumulation within degenerated intervertebral discs, is a radiographic hallmark of advanced spinal degeneration. Although this phenomenon is rare, VDP may also rarely present as radiculopathy due to the compression of nerve structures by dynamic gas migration—which is different from typical intervertebral disc protrusion. This phenomenon predominantly affects elderly populations, with computed tomography (CT) imaging serving as the gold standard for detecting hypodense gas pockets and delineating their spatial relationship to nerve roots. Unlike mechanical compression from disc fragments, gas-induced symptoms are uniquely refractory to conservative therapies, necessitating targeted surgical strategies. This report details a 72-year-old female with acute L5 radiculopathy secondary to multilevel VDP, where percutaneous endoscopic interlaminar decompression achieved immediate symptom resolution through precise gas evacuation. The case underscores the critical interplay between imaging interpretation and minimally invasive intervention in addressing this rare yet debilitating complication of spinal degeneration, while advocating for standardized protocols to optimize patient selection and outcomes. https://www.frontiersin.org/articles/10.3389/fsurg.2025.1595166/fullvacuum disc phenomenonmultimodal imaginglumbosacral radiculopathypercutaneous endoscopic interlaminar discectomy (PEID)minimally invasive spine surgery
spellingShingle Longxiao Wu
Saifei Meng
Peng Li
Chunlei Liu
Imaging features and percutaneous endoscopic interlaminar decompression of vacuum disc phenomenon-induced lumbosacral radiculopathy: case report
Frontiers in Surgery
vacuum disc phenomenon
multimodal imaging
lumbosacral radiculopathy
percutaneous endoscopic interlaminar discectomy (PEID)
minimally invasive spine surgery
title Imaging features and percutaneous endoscopic interlaminar decompression of vacuum disc phenomenon-induced lumbosacral radiculopathy: case report
title_full Imaging features and percutaneous endoscopic interlaminar decompression of vacuum disc phenomenon-induced lumbosacral radiculopathy: case report
title_fullStr Imaging features and percutaneous endoscopic interlaminar decompression of vacuum disc phenomenon-induced lumbosacral radiculopathy: case report
title_full_unstemmed Imaging features and percutaneous endoscopic interlaminar decompression of vacuum disc phenomenon-induced lumbosacral radiculopathy: case report
title_short Imaging features and percutaneous endoscopic interlaminar decompression of vacuum disc phenomenon-induced lumbosacral radiculopathy: case report
title_sort imaging features and percutaneous endoscopic interlaminar decompression of vacuum disc phenomenon induced lumbosacral radiculopathy case report
topic vacuum disc phenomenon
multimodal imaging
lumbosacral radiculopathy
percutaneous endoscopic interlaminar discectomy (PEID)
minimally invasive spine surgery
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1595166/full
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AT pengli imagingfeaturesandpercutaneousendoscopicinterlaminardecompressionofvacuumdiscphenomenoninducedlumbosacralradiculopathycasereport
AT chunleiliu imagingfeaturesandpercutaneousendoscopicinterlaminardecompressionofvacuumdiscphenomenoninducedlumbosacralradiculopathycasereport