title: Percutaneous intradiscal aspiration of a lumbar vacuum disc herniation: a case report.
abstract: 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.
authors.forename: Kevin I
authors.initials: KI
authors.lastname: Pak
authors.forename: David C
authors.initials: DC
authors.lastname: Hoffman
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Herzog
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Lutz