Resorption of Lumbar Disk Herniation

Hornung, Alexander; Baker, James D.; Mallow, G. Michael; Sayari, Arash J.; Albert, H; Tkachev, Alexander; An, Howard S.; Samartzis, D

doi:10.2106/jbjs.rvw.22.00148

Cited by 7 publications

(6 citation statements)

References 97 publications

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Section: Discussionmentioning

confidence: 99%

“…The probability of intervertebral disc resorption in lumbar herniations remains uncertain due to the heterogeneity in imaging and morphologic factors [ 7 ]. Currently, the initial size of the herniation and sequestration are factors known to increase the likelihood of disc resorption [ 7 ]. Spontaneous resorption probabilities have been reported as 13% for bulging discs, 41% for protruding discs, 70% for extruding discs, and 96% for sequestered discs [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Non-surgical Restoration of L3/L4 Disc Herniation

Chu,

Sabourdy

2023

Cureus

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We report the case of a 52-year-old Asian man presenting with severe lower back pain and bilateral radiculopathy due to acute L3/L4 disc extrusion, causing severe spinal canal stenosis and bilateral L4 nerve root compression. Following a ten-week conservative management plan consisting of high-velocity, low-amplitude spinal manipulation, adjunctive therapies, and home exercise, the patient experienced significant pain relief, functional improvement, and near resolution of deficits. A six-month follow-up MRI revealed the resolution of the L3/L4 disc extrusion, and the patient remained asymptomatic at nine months. This case highlights the potential for spontaneous resorption of a lumbar disc herniation and symptomatic improvement with conservative management, including chiropractic treatment. A favorable natural course of a disc herniation should be considered when deciding between early surgical intervention and conservative management, warranting further prospective studies to evaluate the effectiveness of chiropractic treatment and the role of spontaneous regression in symptomatic lumbar disc herniation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Non-surgical Restoration of L3/L4 Disc Herniation

Chu,

Sabourdy

2023

Cureus

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“…Furthermore, not all disc tissue will cause radicular pain that radiates along nerve pathways, as some individuals may experience localized back pain without radiation, and will experience discogenic pain rather than nerve compression [22]. Furthermore, in some cases, the body's natural healing process can lead to a resorption or reduction in size of a herniated disc over time; this can occur without the individual ever experiencing significant symptoms [23]. All of the aforementioned variables contribute to the variety in the expression of symptoms among individuals with similar disc herniations.…”

Section: Classification Of Lumbar Disc Herniationmentioning

confidence: 99%

Non-Surgical Approaches to the Management of Lumbar Disc Herniation Associated with Radiculopathy: A Narrative Review

El Melhat,

Youssef,

Zebdawi

et al. 2024

JCM

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Lumbar disc herniation associated with radiculopathy (LDHR) is among the most frequent causes of spine-related disorders. This condition is triggered by irritation of the nerve root caused by a herniated disc. Many non-surgical and surgical approaches are available for managing this prevalent disorder. Non-surgical treatment approaches are considered the preferred initial management methods as they are proven to be efficient in reducing both pain and disability in the absence of any red flags. The methodology employed in this review involves an extensive exploration of recent clinical research, focusing on various non-surgical approaches for LDHR. By exploring the effectiveness and patient-related outcomes of various conservative approaches, including physical therapy modalities and alternative therapies, therapists gain valuable insights that can inform clinical decision-making, ultimately contributing to enhanced patient care and improved outcomes in the treatment of LDHR. The objective of this article is to introduce advanced and new treatment techniques, supplementing existing knowledge on various conservative treatments. It provides a comprehensive overview of the current therapeutic landscape, thereby suggesting pathways for future research to fill the gaps in knowledge. Specific to our detailed review, we identified the following interventions to yield moderate evidence (Level B) of effectiveness for the conservative treatment of LDHR: patient education and self-management, McKenzie method, mobilization and manipulation, exercise therapy, traction (short-term outcomes), neural mobilization, and epidural injections. Two interventions were identified to have weak evidence of effectiveness (Level C): traction for long-term outcomes and dry needling. Three interventions were identified to have conflicting or no evidence (Level D) of effectiveness: electro-diagnostic-based management, laser and ultrasound, and electrotherapy.

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“…Имеются данные о том, что регрессия более вероятна при больших экструзиях, секвестрированных грыжах и при наличии краевого накопления контрастного вещества. Эти изменения могут быть связаны с более выраженной воспалительной реакцией [9, 44,53]. В представленном нами клиническом наблюдении отмечался полный регресс большой секвестрированной грыжи МПД без изменений типа Modic по данным МРТ, что согласуется с данными других авторов.…”

Section: по данным кокрейновского обзора (2017) [21] нпвп показали до...unclassified

Metamorphosis of a herniated lumbar disc

Isaykin,

Akhmedzhanova,

Fedoseev

et al. 2023

RJTAO

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Compression of nerve roots by herniated intervertebral discs (IVD) is a major cause of lumbosacral radiculopathy and often causes problems in patient management. We present a case report of a patient whose initial pain was axial discogenic in nature, probably due to a fissure of the annulus fibrosus, and who later developed LIII–IV radiculopathy. The timing of formation of a sequestered IVD hernia was recorded on MRI. There was no prolonged gradual formation of IVD hernia (bulging, fissure, protrusion, extrusion/sequestration), an acute formation of disc herniation occurred. Conservative treatment, including nonpharmacological (McKenzie gymnastics, educational program) and drug treatment (nonsteroidal anti-inflammatory drugs, anticonvulsants), as well as minimally invasive measures (epidural administration of local anesthetics and glucorticoids), allowed rapid regression of clinical symptoms and improvement of functional and emotional status. MRI of the lumbar spine performed six months after onset showed complete resorption of the IVD hernia. The patient follows ergonomic recommendations and performs therapeutic exercises (Nordic walking); no deterioration was observed within 9 months.

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Resorption of Lumbar Disk Herniation

Cited by 7 publications

References 97 publications

Non-surgical Restoration of L3/L4 Disc Herniation

Non-surgical Restoration of L3/L4 Disc Herniation

Non-Surgical Approaches to the Management of Lumbar Disc Herniation Associated with Radiculopathy: A Narrative Review

Metamorphosis of a herniated lumbar disc

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