Spontaneous Resorption of Herniated Lumbar Disk: Observational Retrospective Study in 9 Patients.

Herniated lumbar disk Spontaneous resorption

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 31 10 2018
revised: 11 12 2018
accepted: 13 12 2018
medline: 6 1 2019
pubmed: 6 1 2019
entrez: 6 1 2019
Statut: ppublish

Résumé

Spontaneous resorption of herniated lumbar disk was explained in the literature by different mechanisms, and multiple predictive factors for resorption were reported in numerous studies. The purpose of this study was to evaluate the phenomena of spontaneous resorption of herniated lumbar disk without surgery (mechanisms, predictive factors, expected time for resorption, and proper time for conservative treatment). This retrospective clinical case series included 9 patients with herniated lumbar disk on initial magnetic resonance imaging (MRI). The mean age was 39 ± 6.3 years, and the male to female ratio was 2:1. All patients presented with back pain and sciatica without motor deficit. All patients refused surgical intervention; therefore, they were treated conservatively. Patients were followed-up clinically and radiologically (MRI) in the outpatient clinic on regular visits (for 18 months). Spontaneous resorption of herniated disk was found in all patients in a mean time of 8.7 ± 3.2 months. All patients recovered clinically in a mean time of 5.7 ± 1.6 weeks by conservative treatment. Large and/or sequestrated disks were associated with rapid resorption. Early recovery patients showed early spontaneous resorption of the disk. Spontaneous resorption of herniated lumbar disk can occur by different mechanisms (retraction, dehydration, and inflammatory mediated mechanism). Large and/or sequestrated disks are essential predictive factors for rapid spontaneous resorption. Furthermore, early clinical recovery is usually associated with quick resorption of the herniated disk.

Sections du résumé

BACKGROUND BACKGROUND
Spontaneous resorption of herniated lumbar disk was explained in the literature by different mechanisms, and multiple predictive factors for resorption were reported in numerous studies. The purpose of this study was to evaluate the phenomena of spontaneous resorption of herniated lumbar disk without surgery (mechanisms, predictive factors, expected time for resorption, and proper time for conservative treatment).
METHODS METHODS
This retrospective clinical case series included 9 patients with herniated lumbar disk on initial magnetic resonance imaging (MRI). The mean age was 39 ± 6.3 years, and the male to female ratio was 2:1. All patients presented with back pain and sciatica without motor deficit. All patients refused surgical intervention; therefore, they were treated conservatively. Patients were followed-up clinically and radiologically (MRI) in the outpatient clinic on regular visits (for 18 months).
RESULTS RESULTS
Spontaneous resorption of herniated disk was found in all patients in a mean time of 8.7 ± 3.2 months. All patients recovered clinically in a mean time of 5.7 ± 1.6 weeks by conservative treatment. Large and/or sequestrated disks were associated with rapid resorption. Early recovery patients showed early spontaneous resorption of the disk.
CONCLUSIONS CONCLUSIONS
Spontaneous resorption of herniated lumbar disk can occur by different mechanisms (retraction, dehydration, and inflammatory mediated mechanism). Large and/or sequestrated disks are essential predictive factors for rapid spontaneous resorption. Furthermore, early clinical recovery is usually associated with quick resorption of the herniated disk.

Identifiants

pubmed: 30610984
pii: S1878-8750(18)32938-3
doi: 10.1016/j.wneu.2018.12.115
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e453-e459

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

Auteurs

Ahmed Rizk Elkholy (AR)

Neurosurgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt. Electronic address: elkholyneurosurgery@yahoo.com.

Ashraf Mohamed Farid (AM)

Neurosurgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Ebrahim Ahmed Shamhoot (EA)

Neurosurgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Classifications MeSH