Spontaneous Resolution of “Protruded” Lumbar Discs

 

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Zusammenfassung

Abstract

Decreasing size of disc material that has herniated, whether “contained” or “protruded” has previously been described and sometimes this can be so complete that residual material is barely visible. In a retrospective clinical survey, from among almost 2180 consecutive patients admitted during 1994 - 2002 with low back pain; due to our low follow-up ratios and high price of the magnetic resonance imaging (MRI), only 42 patients with a lumbar disc protrusion could be found who had two MRI scans obtained at least five weeks apart. Among these, 4 patients were spotted with a totally resolved disc protrusion. T₂-weighted MRI images were suggesting shrinkage due to dehydration and regression within the annulus of protruded disc fragments that had not fully migrated. Our patients are further examples for total resolution of the large “protruded” disc without any treatment; and since concomitant disc protrusions at other levels persisted, the resolution of these discs is supposed to be spontaneous.

References

• 1 Boden S D, David D O, Dina T S, Patronas N J, Wiesel S W. Abnormal magnetic resonance scans of the lumbar spine in asymptomatic subjects.  J Bone Joint Surg [Am]. 1990;  72 403-408
  PubMedGoogle Scholar
• 2 Matsubara Y, Kato F, Mimatsu K, Kajino G, Nakamura S, Nitta N. Serial changes on MRI in lumbar disc herniations treated conservatively.  Neuroradiology. 1995;  37 378-383
  CrossrefPubMedGoogle Scholar
• 3 Teplick J G, Haskin M E. Spontaneous regression of herniated nucleus pulposus.  Am J Roentgenol. 1985;  145 371-375
  PubMedGoogle Scholar
• 4 Komori H, Shinomiya K, Nakai O, Yamaura I, Takeda S, Furuya K. The natural history of herniated nucleus pulposus with radiculopathy.  Spine. 1996;  21 225-229
  CrossrefPubMedGoogle Scholar
• 5 Maigne J Y, Rime B, Deligne B. Computed tomographic follow-up study of forty-eight cases of non operatively treated lumbar intervertebral disc herniation.  Spine. 1992;  17 1071-1074
  PubMedGoogle Scholar
• 6 Delauche-Cavallier M C, Budet C, Laredo J D, Debie B, Wybier M, Dorfmann H, Ballner I. Lumbar disc herniation: computed tomography scan changes after conservative treatment of nerve root compression.  Spine. 1992;  17 927-933
  PubMedGoogle Scholar
• 7 Fager C A. Observation on spontaneous recovery from intervertebral disc herniation.  Surg Neurol. 1994;  42 282-286
  CrossrefPubMedGoogle Scholar
• 8 Weinreb J C, Wolbarscht L B, Cohen J M, Brown C E, Maravilla K R. Prevalence of lumbosacral intervertebral disc abnormalities on MR images in pregnant and asymptomatic non-pregnant women.  Radiology. 1989;  170 125-128
  CrossrefPubMedGoogle Scholar
• 9 Wiesel S W, Tsourmas N, Feffer H L, Citrin C M, Patronas N J. A study of computer assisted tomography: I. The incidence of positive CAT scans in an asymptomatic group of patients.  Spine. 1984;  9 549-551
  CrossrefPubMedGoogle Scholar
• 10 Deyo R A, Tsui-Wu Y J. Descriptive epidemiology of low-back pain and its related medical care in the United States.  Spine. 1987;  12 264-268
  CrossrefPubMedGoogle Scholar
• 11 Saal J A, Saal J S. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy: an outcome study.  Spine. 1989;  14 431-437
  CrossrefPubMedGoogle Scholar
• 12 Weber H. Lumbar disc herniation: A controlled, prospective study with 10 years of observation.  Spine. 1983;  8 131-139
  CrossrefPubMedGoogle Scholar
• 13 Bozzao A, Gallucci M, Masciocchi C, Aprile I, Barile A, Passeriello R. Lumbar disk herniation: MR imaging assessment of natural history in patients treated without surgery.  Radiology. 1992;  15 135-141
  PubMedGoogle Scholar

Prof. Dr. İ. Semih Keskıl

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