Abstract
We retrospectively reviewed plain radiographs from patients with four different diseases that can cause vertebral collapse: osteoporotic vertebral collapse, spinal infection, spinal metastasis, and multiple myeloma. The objective of the study was to find the percentages of intravertebral vacuum phenomena and vertebral collapse rates in the four groups. The vacuum phenomenon is often observed in osteoporotic compression fractures. However, these phenomena are rarely seen in spinal infection and malignant lesions. Whether the vacuum phenomenon is a benign indicator is not known. We retrospectively reviewed plain radiographs from four groups of patients, including 328 osteoporotic vertebral collapse patients, 317 spinal infection patients, 302 spinal metastasis patients, and 325 multiple myeloma patients. The pattern and occurrence rates of intravertebral vacuum phenomena and vertebral body collapse were analyzed. The occurrence rate of intravertebral vacuum phenomena in patients with osteoporotic vertebral collapse was approximately 18.9%. Only one case of intravertebral vacuum phenomena was observed in patients with spinal infection. Vacuum phenomena were not observed in patients with spinal metastasis. The occurrence rate of intravertebral vacuum phenomena in patients with multiple myeloma was 6.4%. The patterns of intravertebral vacuum phenomena were also analyzed. Intravertebral vacuum phenomena are common in patients with osteoporotic vertebral collapse. Most cases of intravertebral vacuum phenomena are of a benign nature. Moreover, intravertebral vacuum phenomena occur extremely rarely in patients with spinal infection. Such phenomena are also found in patients with multiple myeloma.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Resnick D, Niwayama G, Guerra J Jr, Vint V, Usselman J (1981) Spinal vacuum phenomena: anatomical study and review. Radiology 139:341–348
Hasegawa K, Homma T, Uchiyama S, Takahashi H (1998) Vertebral pseudarthrosis in the osteoporotic spine. Spine 23:2201–2206
Sarli M, Perez Manghi FC, Gallo R, Zanchetta JR (2005) The vacuum cleft sign: an uncommon radiological sign. Osteoporos Int 16:1210–1214
Samuel E (1948) Vacuum intervertebral discs. Br J Radiol 21:337–339
Morishita K, Kasai Y, Uchida A (2008) Clinical symptoms of patients with intervertebral vacuum phenomenon. Neurologist 14:37–39
Pate D, Katz A (1979) Clostridia discitis: a case report. Arthritis Rheum 22:1039–1040
Beguiristain JL, de Pablos J, Llombart R, Gomez A (1986) Discitis due to Clostridium perfringens. Spine 11:170–172
Bielecki DK, Sartoris D, Resnick D, Van Lom K, Fierer J, Haghighi P (1986) Intraosseous and intradiscal gas in association with spinal infection: report of three cases. AJR Am J Roentgenol 147:83–86
Bhalla S, Reinus WR (1998) The linear intravertebral vacuum: a sign of benign vertebral collapse. AJR Am J Roentgenol 170:1563–1569
Uetani M, Hashmi R, Hayashi K (2004) Malignant and benign compression fractures: differentiation and diagnostic pitfalls on MRI. Clin Radiol 59:124–131
Libicher M, Appelt A, Berger I, Baier M, Meeder PJ, Grafe I, Dafonseca K, Noldge G, Kasperk C (2007) The intravertebral vacuum phenomenon as specific sign of osteonecrosis in vertebral compression fractures: results from a radiological and histological study. Eur Radiol 17:2248–2252
Maldague BE, Noel HM, Malghem JJ (1978) The intravertebral vacuum cleft: a sign of ischemic vertebral collapse. Radiology 129:23–29
Pappou IP, Papadopoulos EC, Swanson AN, Cammisa FP Jr, Girardi FP (2008) Osteoporotic vertebral fractures and collapse with intravertebral vacuum sign (Kummel’s disease). Orthopedics 31:61–66
Kumpan W, Salomonowitz E, Seidl G, Wittich GR (1986) The intravertebral vacuum phenomenon. Skeletal Radiol 15:444–447
Gagnerie F, Taillan B, Euller-Ziegler L, Ziegler G (1987) Intravertebral vacuum phenomenon in multiple myeloma. Clin Rheumatol 6:597–599
Schabel SI, Moore TE, Rittenberg GM (1979) Vertebral vacuum phenomenon: a radiographic manifestation of metastatic malignancy. Skeletal Radiol 4:154–156
Lane JI, Maus TP, Wald JT, Thielen KR, Bobra S, Luetmer PH (2002) Intravertebral clefts opacified during vertebroplasty: pathogenesis, technical implications, and prognostic significance. AJNR Am J Neuroradiol 23:1642–1646
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174
Chang MC, Wu HT, Lee CH, Liu CL, Chen TH (2006) Tuberculous spondylitis and pyogenic spondylitis: comparative magnetic resonance imaging features. Spine 31:782–788
McDonald RJ, Trout AT, Gray LA, Dispenzieri A, Thielen KR, Kallmes DF (2008) Vertebroplasty in multiple myeloma: outcomes in a large patient series. AJNR Am J Neuroradiol 29:642–648
Lee B, Franklin I, Lewis JS, Coombes RC, Leonard R, Gishen P, Stebbing J (2009) The efficacy of percutaneous vertebroplasty for vertebral metastases associated with solid malignancies. Eur J Cancer 45:1597–1602
Acknowledgments
No funds were received in support of this work.
Conflict of interest
No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Feng, SW., Chang, MC., Wu, HT. et al. Are intravertebral vacuum phenomena benign lesions?. Eur Spine J 20, 1341–1348 (2011). https://doi.org/10.1007/s00586-011-1789-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-011-1789-3