Case Report

HSS Journal

, Volume 7, Issue 1, pp 89-93

First online:

Percutaneous Intradiscal Aspiration of a Lumbar Vacuum Disc Herniation: A Case Report

  • Kevin I. PakAffiliated withPhysiatry Department, Hospital for Special Surgery
  • , David C. HoffmanAffiliated withPhysiatry Department, Hospital for Special Surgery
  • , Richard J. HerzogAffiliated withDepartment of Radiology, Hospital for Special Surgery
  • , Gregory E. LutzAffiliated withPhysiatry Department, Hospital for Special Surgery Email author 

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We report a case of an 83-year-old gentleman presenting with acute low back pain and radicular left lower extremity pain after golfing. A magnetic resonance imaging (MRI) of the lumbar spine revealed a low-signal-density lesion compressing the L5 nerve. A computed tomography scan was then ordered, confirming an extra-foraminal disc protrusion at the L5–S1 level, containing a focus of gas that was compressing the left L5 nerve root and communicating with the vacuum disc at L5–S1. After a failed left L5 transforaminal epidural steroid injection, the patient was brought back for a percutaneous intradiscal aspiration of the vacuum disc gas. This resulted in immediate relief for the patient. A follow-up MRI performed 2 months after the procedure found an approximate 25% reduction in the size of the vacuum disc herniation. Six months after the procedure, the patient remains free of radicular pain. This case report suggests that a percutaneous aspiration of gas from a vacuum disc herniation may assist in the treatment of radicular pain.


vacuum disc phenomenon lumbar spine intervertebral disc epidural gas percutaneous procedure