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Spine and Back Health

Vacuum phenomenon

04/29/2008

Question:

I am a female age 55. Please tell me if it is normal for a woman my age to have so much wrong with her spine. My doctor said my MRI is normal. The MRI showed multi -level degenerative disc disease, foraminal encroachment, facet disease and mild stenosis in the cervical and lumbar spine. Also, x-rays of the mild thoracic area showed curvature of the midthoracic spine convex right, with more severe scoliosis in the lumbar spine, and mild dorsal kyphosis. The vertebral body heights appeared to maintained. Moderate osteophytes were present with VACUUM PHENOMENON at several disk levels in the mid and lower thoracic spine. What is this? Could I have a systemic disease? What could be causing all this? I have leg function loss and feel sick all the time. PLEASE HELP ME! My doctor keeps ignoring me. I begged my doctor to give me a DEXA scan, and it took me two years until he finally ordered one yesterday. (I am 5` 3 1/4` inches tall. In 2005, I was 5` 5 1/2" inches tall.) I know you do not diagnose in this forum, but could you PLEASE tell me if I should ask my doctor for any specific tests, or should ask to be referred to a particular specialist?

Answer:

Hello, thank you for your question. Vacuum disc phenomenon is a part of degeneration of the spinal discs. As they degenerate (wear out), the discs develop small pockets of air within them. As a general rule, vacuum disc sign is suggestive of more severe disc degeneration (although not always).

You have asked many questions that I can’t answer without knowing your full medical history and physical examination. It is unlikely that you have a systemic disease. Degeneration of the spine is very common (up to 85% of all people in the US will develop back pain at some time in their lives). Do you smoke? Do many of your family have spinal problems? These and many other factors can be involved. You say you have “leg function loss” – do you mean weakness? You say you feel “sick” all the time – I’m not sure what that means.

In the end, if you do not feel that your doctor is taking your concerns seriously, you should either demand referral to a spine specialist, or find a different doctor. Good luck.

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Response by:

David J Hart, MD David J Hart, MD
Associate Professor of Neurosurgery
School of Medicine
Case Western Reserve University