Intervertebral vacuum phenomenon – prevalence and severity CT-scan analysis in patients older than 50 years: a retrospective cohort study

Abstract

Background Chronic low back pain secondary to degenerative changes in the spine is a common cause of disability, and disc degeneration is one of the most frequent imaging findings. Intervertebral vacuum phenomenon (IVP) is usually observed in advanced degeneration. Recently, this phenomenon has gained interest due to a relatively new surgical technique called percutaneous discoplasty, aimed at treating low back pain secondary to degenerative disc disease in elderly patients. Purpose To analyze the prevalence and related factors of the vacuum phenomenon in adult patients. Material and Methods A retrospective cohort study was performed of patients who underwent abdominal computed tomography (CT) for non-spine-related reasons. Age, body mass index, smoking, and CT-based characteristics as presence of IVP, subchondral sclerosis, and facet joint degeneration at the lumbar spine from L1 to the sacrum were included in order to determine the prevalence of the vacuum phenomenon in this population and establish a relationship between this condition and patient demographics and other signs of spine degeneration, such as sclerosis and facet joint disease. Results A total of 238 patients were included in the study (114 men, 124 women; mean age = 75.6 ± 12.3 years. In total, 91 (38%) patients had at least one level of IVP; 59 (25%) patients exhibited subchondral sclerosis, and 235 (98%) facet joint degeneration. Among risk factors, age, smoking, and subchondral sclerosis were significantly associated with the presence of vacuum. Conclusion IVP was present in 38% of participants. Risk factors associated with vacuum were age, smoking, and subchondral sclerosis.

Severe Intervertebral Vacuum Phenomenon is Associated With Higher Preoperative Low Back Pain, ODI, and Indication for Fusion in Patients With Degenerative Lumbar Spondylolisthesis

“…9,10 As the discs continue in the degenerative cascade, some signs of moderate or advanced degeneration can be observed such as the presence of an intervertebral vacuum phenomenon (IVP). 11,12 IVP has been associated with LBP and is also considered a sign of advanced degeneration. 13 Historically, IVP had a descriptive meaning with apparently little clinical impact.…”

“…Moreover, lumbar degeneration also implies changes in the facet joints and seems to be an important cause of back pain 9,10 . As the discs continue in the degenerative cascade, some signs of moderate or advanced degeneration can be observed such as the presence of an intervertebral vacuum phenomenon (IVP) 11,12 …”

Association between Modic changes and intervertebral vacuum phenomenon severity in patients undergoing percutaneous cement discoplasty

“…There are many factors that have been proposed as contributors to LBP as general characteristics in patients, such as obesity, aging, and smoking, as well as specific lumbar imaging findings, such as disc and facet degeneration, Modic changes, and intervertebral vacuum phenomenon (IVP) (7)(8)(9)(10).…”