Clinical recovery in Spontaneous lumbar disc resorption may alter the decision of lumbar disc surgery in the future.

Abstract

Background: Different processes have been proposed in the literature to explain the spontaneous resorption of herniated lumbar discs, and numerous studies have found numerous resorption-predictive features. The goal of this study was to assess the clinical improvement and correlation with radiological resorption of lumbar disc herniation (LDH) hence we can decide appropriate time for conservative management. Materials and methods: 18 patients who had LDH on initial magnetic resonance imaging (MRI) were included in this retrospective analysis. The average age was 36.9 ± 7.2 years, with eleven cases predominantly male. A total of 100% of the patients had sciatica, and 55.6% had pain in their lower backs. Since none of the patients underwent surgery, they were all given conservative care. For 8 to 11 months, patients were followed up clinically and radiologically (using an MRI) in the outpatient clinic. Results: 44.4% of patients had L5-S1 disc prolapse whereas 55.6% had L4-5 level affected. Sequestration affected 66.7% while Extruded disc was seen in 33.3%. Conservative management revealed that 66.11 % underwent spontaneous resorption of the ruptured disc in a mean time of 9.2 ± 1.1 months as seen radiologically in the MRI. Clinical improvement occurred in all patients in a mean of 5.9 ± 1.2. Conclusion: Spontaneous resorption of a herniated lumbar disc, which can happen due to retraction, dehydration, or an inflammatory-mediated mechanism, has become a more common event in lumbar disc prolapse. Clinical recovery typically occurred prior to LDH radiological improvement. The clinical resolution of symptoms and the radiological resolution of LDH were not shown to be significantly correlated.