Clinical Improvement After Spontaneous Partial or Complete Absorption 0f Herniated Lumbar Disc.

Abstract

Background Data: Intervertebral disc herniation is a common disease that usually occurs in middle aged active persons. It presents by back pain and involved nerve root radiculopathy. Some neurologic symptoms in the majority of patients improve after a period of conservative therapy due to regression in the size of the herniated disc. The exact mechanism of disc regression is not yet clear, however clinical improvement and MRI follow up can document this condition. Study Design: Retrospective clinical case review. Purpose: To assess the clinical improvement of patients with herniated lumbar disc if it occurred by the conservative treatment due to partial or complete spontaneous disc absorption without conveying surgery. Patients and Methods: Here we present fifty cases with single symptomatic disc herniation followed for one year showing the extent of clinical improvement by the conservative treatment, MRI changes and the fate of these fifty patients during and after a one year period of follow up. Male to female ratio was 3:2. The mean age was 38.6 years. Results: History of trauma preceding the disc herniation was given only in 5 (10%) patients. Left sciatica was reported in 34 (68%) and right in 16 (32%) patients. Motor weakness was found only in 5 (10%) patients. L4-5 was the commonest disc to be involved and was found to be herniated in 26 (52%) patients. 44 (88%) patients showed improvement without surgical intervention, while 6 (12%) patients only were operated upon. Conclusion: Herniated intervertebral discs have the potentials for spontaneous regression. Conservative treatment can be tried for all cases even those with mild neurologic deficits at least for 2 months. Surgical treatment should be applied only for patients with severe neurologic deficits or for those with persistent intractable sciatica. (2012ESJ031)

Keywords

• Lumbar
• herniated disc
• spontaneous regression