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.
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The study is a case report or individual case and therefore its level of evidence is a 3.
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Pak, K.I., Hoffman, D.C., Herzog, R.J. et al. Percutaneous Intradiscal Aspiration of a Lumbar Vacuum Disc Herniation: A Case Report. HSS Jrnl 7, 89–93 (2011). https://doi.org/10.1007/s11420-010-9168-x
- vacuum disc phenomenon
- lumbar spine
- intervertebral disc
- epidural gas
- percutaneous procedure