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Dynamic Spinal Stenosis in Intradiscal Vacuum Phenomenon: Insights from Standing Weight Bearing CT Myelography

Year: 2026

Type: article

Abstract: Low back pain and degenerative disc disease are common causes of spinal canal stenosis, yet conventional supine imaging may underestimate pathology evident under physiologic loading. The intradiscal vacuum phenomenon (IVP), a marker of disc degeneration, has unclear dynamic mechanical implications. We describe a combined standing and recumbent CT myelography technique, demonstrating that while supine imaging shows degenerative changes with IVP, upright cone-beam CT reveals disc space collapse, increased posterior disc bulge, and more severe canal narrowing. In these three illustrative cases, standing CT myelography depicted dynamic disc-space collapse, increased posterior disc bulge, and canal narrowing that were less evident on supine imaging. These observations are hypothesis-generating; prospective studies are needed to determine whether IVP, with or without endplate sclerosis, predicts dynamic interspace collapse.

Source: American Journal of Neuroradiology

DOI: 10.3174/ajnr.a9495

Authors: Mohamed A. Hamza, Norbert G. Campeau, Ahmed O. El Sadaney, Ben A. Johnson-Tesch, Theodore A. Betting, Steven A. Messina, Ian T. Mark

Institution: Mayo Clinic

Language: English

Topic: Spine and Intervertebral Disc Pathology

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

OpenAlex ID: W7165767876

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