Predictive Factors for Resorption in Lumbar Disc Herniation: A Systematic Review

Area of Science:

• Spinal medicine
• Radiology
• Orthopedics

Background:

• Lumbar disc herniation (LDH) involves intervertebral disc (IVD) protrusion.
• Spontaneous resorption of herniated IVD is possible but mechanisms and predictors are unclear.
• Comprehensive understanding of LDH resorption is needed for effective clinical management.

Purpose of the Study:

• To systematically review and summarize predictive factors for spontaneous lumbar disc herniation (LDH) resorption.
• To provide evidence-based guidance for clinicians in therapeutic decision-making for LDH.
• To consolidate current knowledge on factors influencing LDH resorption.

Main Methods:

• Comprehensive literature search across PubMed, Web of Science, Embase, and Cochrane Library up to July 2024.
• Inclusion of studies reporting predictors of LDH resorption with imaging follow-up (CT/MRI).
• Quality assessment using the ROBINS-I tool by two independent reviewers.

Main Results:

• Twenty-two studies were included from 1115 publications.
• Predictive factors for LDH resorption fall into five categories: clinical, LDH type/size, IVD composition, imaging features, and spinal physiology.
• A limitation is the scarcity of high-quality prospective studies.

Conclusions:

• LDH resorption probability can be predicted using five key aspects.
• Identifying high-resorption probability cases can optimize conservative treatment selection and success rates.
• Large-scale prospective studies are recommended to validate these predictive factors for LDH resorption.