A case report of vacuum sign surgery for the inner recess of lumbar spinal canal

• The occurrence of severe clinical symptoms caused by vacuum sign in patients is rare, and most conservative treatments will have good postoperative outcomes. • This article reports on a patient with vacuum syndrome in the inner recess of the lumbar spinal canal who underwent surgical treatment. The formation of intervertebral disc vacuum sign can be observed in late stage degenerative changes of the lumbar disc. In 1937, Magnusson first proposed intervertebral disc vacuum sign, which refers to the accumulation of gas caused by disc dehydration and fissure formation during the degenerative process of the lumbar disc. The vacuum phenomenon can occur around the articular processes, within the spinal canal, and in the intervertebral disc, with the most common being in the intervertebral disc. The vacuum phenomenon causes the mechanical receptors, injury receptors, and pressure receptors around the intervertebral disc to react more strongly than usual, thereby increasing lower back pain. A small amount of vacuum phenomenon can also occur in the spinal canal and lateral recess, inducing lower limb numbness and pain, which needs to be distinguished from sciatica caused by intervertebral disc herniation. This article presents a case of vacuum syndrome in the inner recess of the lumbar spinal canal, which underwent surgical treatment and achieved good therapeutic effects. And the characteristics, diagnosis, and treatment of lumbar vacuum sign were discussed.