Lumbar herniated disc: spontaneous regression

Area of Science:

• Neurosurgery
• Orthopedics
• Physical Medicine and Rehabilitation

Background:

• Low back pain is a prevalent condition causing significant disability and leading to neurosurgery consultations.
• Lumbar disc hernia (LDH) is a common cause of low back pain and associated neurological deficits.

Purpose of the Study:

• To evaluate the therapeutic outcomes of conservative treatment for lumbar disc hernia (LDH).
• To assess the efficacy of bed rest and medical therapy in managing LDH patients.

Main Methods:

• A retrospective cohort study involving 23 patients diagnosed with LDH at L3-L4, L4-L5, or L5-S1 levels.
• Patients received conservative treatment including bed rest and medical therapy.
• Data collected included neurological examination findings, treatment duration, and time to symptomatic recovery.

Main Results:

• All patients experienced benefits from conservative treatment, with reported symptom improvement.
• Radiological improvement of LDH was observed concurrently with clinical recovery on MRI scans.
• The average duration for symptomatic recovery and/or regression of LDH symptoms was 13.6 months.

Conclusions:

• Lumbar disc hernias can regress with conservative management, including medical treatment and rest, without the need for surgery.
• Radiological recovery in LDH patients treated conservatively is possible and should be considered.
• Conservative treatment should be prioritized for LDH patients without indications for emergent surgery.