Spontaneous regression of a large calcified thoracic disk extrusion

Oligane, Hayley C.; Rongo, Jean; Agarwal, Vikas; Branstetter, Barton F.

doi:10.1007/s00256-018-2887-7

Cited by 9 publications

(17 citation statements)

References 16 publications

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“…Such studies, based on magnetic resonance imaging (MRI) and computed tomography (CT)data, have documented that disc lesions can become smaller and can even completely resolve. [ 9 , 12 , 13 ] The phenomenon of LDH reabsorption is now recognized, and its overall incidence has reached 66.66% of LDH cases, according to a meta-analysis. [ 14 ]…”

Section: Introductionmentioning

confidence: 99%

Clinical research for whether the Traditional Chinese medicine could promote the resorption of lumbar disc herniation: a randomized controlled trial

et al. 2020

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Lumbar disc herniation (LDH) is a common, disabling musculoskeletal disorder. Magnetic resonance imaging has clarified the natural history of lumbar disc lesions and has documented that disc lesions can become smaller and can even be completely resorbed. Previous studies have confirmed that some traditional Chinese medicine (TCM) therapies can promote resorption of the protrusion. However, high-quality research evidence is needed to support the effectiveness of the protocol. Objective: This clinical trial aims to establish whether TCM can promote the resorption of LDH and to assess the efficacy of such therapy for LDH, thereby evaluating its clinical effect. Methods: The present study design is for a single-center, 2-arm, open-label randomized controlled trial. A total of 150 eligible LDH patients will be randomly assigned to either a TCM treatment group or a control group in a 1:1 ratio. Patients in the TCM group will be administered a TCM decoction for 4 weeks. Patients in the conventional drug control group will be instructed to take a specific daily dose of celecoxib. The primary outcome measure is the change from baseline in the volume of the protrusion, as assessed using MR images. Secondary outcome measures include visual analog scale pain scores and Japanese Orthopaedic Association scores assessed at 3 and 6 months. Discussion: The design and methodological rigor of this trial will allow evaluation of the basic clinical efficacy and safety data for TCM in the treatment of patients with LDH. The trial will also assess whether TCM can promote the resorption of LDH. This research will therefore help provide a solid foundation for the clinical treatment of LDH and for future research in TCM therapy. Trial registration: ChiCTR1900022377.

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Section: Introductionmentioning

confidence: 99%

Clinical research for whether the Traditional Chinese medicine could promote the resorption of lumbar disc herniation: a randomized controlled trial

et al. 2020

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“…We reviewed the published studies of calcification of nucleus pulposus and/or calcific discitis in adults [Table 1]. [12345678910121314151617181920212223242526] The collected data in this literature review included demographic data (i.e., gender and age of the patient), level of involving spine, symptoms of patient, location or extension of calcified disc, probably precipitating event, the presence of bone marrow edema on MRI, the occurrence and follow-up time of spontaneous regression, treatment, and outcome of patient.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the soft consistency of the calcified disc material, even complete posterior extrusion of a calcified disc with severe spinal cord compression, some patients with calcific discitis can manifest with asymptomatic, chronic symptoms, or gradually progressive myelopathy. [1126] Xu et al [4] reported successful conservative treatment in two adult patients, even with the presence of early myelopathy from giant calcified discs. Complete spontaneous resorption of giant herniated discs occurred within 6 months after the initial presentation.…”

Section: Discussionmentioning

confidence: 99%

“…Another study by Harshavardhana et al [25] demonstrated spontaneous regression of a large symptomatic calcified extruded thoracic discover 2½ months. Recently, Oligane et al [26] also disclosed spontaneous regression of a large calcified thoracic disc extrusion with spinal cord edema and signal changes on MRI in 8 months. In opposition, giant calcified degenerative discs have hard consistency and produce myelopathy, mostly treated with surgery.…”

Section: Discussionmentioning

confidence: 99%

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Acute calcific discitis or symptomatic calcified schmorl's node of the upper thoracic spine in an adult: A case report and literature review

2019

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We describe a patient with acute calcific discitis following symptomatic Schmorl's node (SN) of upper thoracic spine. A 28-year-old female suffered from sudden severe pain in mid-thoracic, left scapular area, radiating to her chest. Plain radiography of the thoracic spine showed calcification in T3–4 intervertebral disc space. Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the spine demonstrated calcification of the T3–T4 nucleus pulposus, migrating into the inferior of T3 vertebral body with reactive bone marrow edema. By conservative treatment with multidrug therapy, the pain subsided and disappeared in 3 months. Follow-up CT scan and MRI of the thoracic spine confirmed complete resolution of calcified SN and reactive bone marrow edema.

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“…Three patients were reported in two French-language articles, and four patients were reported in four English-language articles. 1,5,[7][8][9][10]…”

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confidence: 99%

Spontaneous regression and near disappearance of a calcified herniated thoracic disc in a 44-year-old male: illustrative case

Utter¹,

Cavanaugh²,

Schouwen³

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Herniation of an intervertebral disc (IVD) is found predominantly in the lumbar and cervical spine of both children and adults, but herniated IVDs of the thoracic spine are a rare occurrence. However, approximately 40% of herniated thoracic disc cases are calcified. Approximately 0.65% of all spinal herniations are calcified herniated thoracic discs (CHTDs). CHTDs can be treated conservatively or invasively, depending on the symptoms and degree of neurological deficit present. OBSERVATIONS The authors report a 44-year-old male with near complete reabsorption and disappearance of a CHTD. A review of the available literature indicates that there are only seven adult patients in whom this phenomenon has been reported. LESSONS Determining the best form of invasive treatment is a challenge for surgeons given the complexity of this condition. While the disappearance of calcified herniated discs of the lumbar and cervical spine has been reported, reports of the regression of CHTDs are rare. The disappearance of CHTDs is more commonly reported in children who undergo conservative treatment, while surgery is reserved for children who experience progressive pain and neurological deficit. Given the success of conservative treatment of CHTDs in children, conservative treatment methods should be considered when treating mildly symptomatic adults.

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Spontaneous regression of a large calcified thoracic disk extrusion

Cited by 9 publications

References 16 publications

Clinical research for whether the Traditional Chinese medicine could promote the resorption of lumbar disc herniation: a randomized controlled trial

Clinical research for whether the Traditional Chinese medicine could promote the resorption of lumbar disc herniation: a randomized controlled trial

Acute calcific discitis or symptomatic calcified schmorl's node of the upper thoracic spine in an adult: A case report and literature review

Spontaneous regression and near disappearance of a calcified herniated thoracic disc in a 44-year-old male: illustrative case

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