Analysis of intervertebral vacuum phenomenon in patients with low back pain: a retrospective analysis of 298 patients

English Keywords:Low back pain  Intervertebral vacuum phenomenon  Intervertebral disc degeneration  Modic changes  Subchondral sclerosis

English Abstract:

  【Abstract】 Objectives: To obtain the incidence rate of intervertebral vacuum phenomenon in patients with low back pain, to clarify the correlations between intervertebral vacuum phenomenon and severe lumbar disc degeneration, Modic changes and subchondral sclerosis, and to analyze the risk factors for intervertebral vacuum phenomenon. Methods: A retrospective analysis was conducted on the patients with low back pain treated in the Department of Spinal Surgery of Northern Jiangsu Province Hospital Affiliated to Yangzhou University from August 2022 to August 2023, and the included patients were divided into two groups of intervertebral vacuum phenomenon group and non-intervertebral vacuum phenomenon group for correlations and risk factors′ anlysis. Intervertebral vacuum phenomenon and subchondral sclerosis in all lumbar segments were evaluated according to three-dimensional CT images, lumbar disc degeneration grades and Modic changes were evaluated according to MRI. Chi-square test was used for categorical variables, independent t-test was used for continuous variables, logistic regression analysis was used for risk factor analysis, and odds ratio(OR) and 95% confidence interval(CI) of each influencing factor of intervertebral vacuum phenomenon were determined, receiver operating characteritics (ROC) curve was used to further demonstrate the correlations between the vacuum phenomenon and influencing factors. Results: A total of 298 patients with low back pain were enrolled, including 103 males and 195 females, aged 62.34±8.76 years old, and 118 cases were in the intervertebral vacuum phenomenon group and 180 cases in the non-intervertebral vacuum phenomenon group. The incidences of intervertebral vacuum phenomenon, severe lumbar disc degeneration, Modic changes and subchondral sclerosis were 39.60%(n=118), 76.17%(n=227), 66.78%(n=199), 27.18%(n=81), respectively. Intervertebral vacuum phenomenon was significantly related to severe lumbar intervertebral disc degeneration(OR=8.960), modic changes (OR=5.086) and subchondral sclerosis(OR=2.954). Age (OR=1.125, P<0.001), body mass index(BMI)(OR=1.316, P<0.001) and smoking (OR=12.755, P=0.035) were risk factors of intervertebral vacuum phenomenon. Conclusions: Intervertebral vacuum phenomenon is significantly associated with severe lumbar intervertebral disc degeneration, Modic changes and subchondral sclerosis in patients with chronic low back pain. In addition, age, BMI and smoking are risk factors for intervertebral vacuum phenomenon.