[Natural course in lumbar disk prolapse]

This study reports on 74 patients with lumbar nucleus prolapse (NP) and nerve root symptoms. In all patients the clinical diagnosis was confirmed using a CT-Scan. After 1.7 y a clinical follow-up was performed. Four patients have required surgery in the meantime. Ninety percent of the patients treated conservatively experienced marked pain relief and generally appreciated the results of conservative treatment. Nevertheless, 67% had some complaints. The neurological findings showed essential improvement even in cases of severe paresis. Follow-up CT scans performed in 35 of these patients and in a control group of 23 patients showed partial regression of the prolapse at an average of 48.3% and 50.4%, respectively. The NP disappeared in 3 with no regression in 2 cases. If regression occurred, it apparently took place during the first 6 months. Regression of NP and clinical improvement showed no positive correlation. The investigation demonstrated fair results with conservative therapy even in cases with minor regression.