{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:27:52Z","timestamp":1768004872187,"version":"3.49.0"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOTT"],"abstract":"<jats:p>Vacuum phenomenon is a commonly observed radiological entity in the degenerated intervertebral discs of the lumbar spine in the elderly population. The entity is frequently asymptomatic. Although disc herniation containing gas (DH-CoG) is commonly associated with the vacuum phenomenon, DH-CoG associated with clinical symptoms is a rare condition. There are very few reports which have histologically demonstrated the existence of the gas itself within DH-CoG. Herein, we report a rare case of a 65-year-old female with symptomatic DH-CoG at L5\/S1. The patient was admitted to our hospital with a one-month history of pain in the left buttock and leg in addition to neurogenic claudication. Roentgenograms illustrated a degenerative lumbar spine with the vacuum phenomenon at the L5\/S1 disc space. Computed tomography showed a round and low-density lesion within the spinal canal at left L5\/S1. Additionally, a lesion characterized by an iso- and partially hypointense signal on T1 and hypointense signal on T2 was detected in magnetic resonance imaging (MRI)  by the spin-echo method. The decision for posterior lumbar interbody fusion surgery using pedicle screws was made as the symptoms had not responded to the conservative treatment. After a degenerated prolapsed nucleus was carefully extracted, the specimen was sent to the laboratory for histopathological analysis. The prolapsed nucleus of DH-CoG histologically showed many small vacuoles containing degenerated mucopolysaccharides. The left leg pain drastically resolved on the first post-operative day, and no recurrence had been observed. Degenerated mucopolysaccharide may be a precursor of nitrogen or \u201cthe gas itself\u201d in DH-CoG. Surgical intervention for DH-CoG should be considered if conservative treatment fails.\n\nCite this article as: Okuyama K, Kido T, Miyakoshi N, Shimada Y. Histological demonstration of the gas precursor in a symptomatic L5-S1 disc herniation containing gas: A case report. Acta Orthop Traumatol Turc 2020; 54(6): 647-50.<\/jats:p>","DOI":"10.5152\/j.aott.2020.19161","type":"journal-article","created":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T02:30:51Z","timestamp":1609381851000},"page":"647-650","source":"Crossref","is-referenced-by-count":4,"title":["Histological demonstration of the gas precursor in a symptomatic L5-S1 disc herniation containing gas: A case report"],"prefix":"10.5152","volume":"54","author":[{"given":"Koichiro","family":"Okuyama","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadato","family":"Kido","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohisa","family":"Miyakoshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoichi","family":"Shimada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2020,12,30]]},"container-title":["Acta Orthopaedica et Traumatologica Turcica"],"original-title":[],"link":[{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/download\/3630\/3576","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:49:20Z","timestamp":1763462960000},"score":1,"resource":{"primary":{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/view\/3630"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,30]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,1,6]]}},"URL":"https:\/\/doi.org\/10.5152\/j.aott.2020.19161","relation":{},"ISSN":["2589-1294","1017-995X"],"issn-type":[{"value":"2589-1294","type":"electronic"},{"value":"1017-995X","type":"print"}],"subject":[],"published":{"date-parts":[[2020,12,30]]}}}