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How Does Resorption Differ Among Single-Level and Multilevel Lumbar Disc Herniations? A Prospective Multi-Imaging and
Alexander L Hornung1,2, Samuel S Rudisill1,2, J Nicolas Barajas1,2
1Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
Spine
|February 12, 2024
Summary
Spinal disc resorption occurs similarly for single-level and multilevel lumbar disc herniations (LDH). Patients with multilevel LDH often have higher BMI and specific endplate defects, but conservative management is effective for all.
Area of Science:
- Spine Surgery
- Radiology
- Orthopedics
Background:
- Lumbar disc herniation (LDH) is a common spinal condition.
- Spontaneous resorption is a known, yet poorly understood, healing mechanism for LDH.
- Understanding differences in multilevel LDH is crucial for effective treatment.
Purpose of the Study:
- To compare patient factors, MRI findings, and resorption outcomes between single-level and multilevel LDH.
- To characterize spontaneous disc resorption in different LDH presentations.
- To inform treatment strategies for lumbar disc herniation.
Main Methods:
- Prospective case series of 90 patients with acute symptomatic LDH (2017-2019).
- Baseline data included demographics and MRI characteristics.
- Follow-up MRIs every three months to assess resorption and healing.
Main Results:
- Multilevel LDH (17/90 patients) was associated with higher BMI and specific endplate defects (L3/L4, L4/L5).
- No significant differences in resorption rates or time to resolution were observed between single-level and multilevel LDH.
- MRI phenotypes, apart from endplate defects, were similar between groups.
Conclusions:
- Spontaneous resorption rates are comparable for single-level and multilevel LDH.
- Multilevel LDH patients may present with higher BMI and specific endplate defects.
- Conservative management is effective for both single-level and multilevel LDH.
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