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CT changes after conservative treatment for lumbar disk herniation

R Dullerud¹, P H Nakstad

¹Department of Radiology, Ullevaal University Hospital, Oslo, Norway.

Acta Radiologica (Stockholm, Sweden : 1987)

|September 1, 1994

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Conservative treatment for lumbar disc herniations showed that smaller herniations often decreased in size, correlating with successful outcomes. Diffuse disc bulges, however, did not regress and were linked to poor results.

Area of Science:

Radiology
Orthopedics
Neurosurgery

Background:

Lumbar disc herniations and bulges are common causes of low back pain.
Conservative treatment is frequently employed, but its long-term effects on disc morphology are not fully understood.

Purpose of the Study:

To evaluate changes in lumbar disc herniations and bulges after conservative treatment.
To correlate imaging findings with clinical outcomes.

Main Methods:

Follow-up computed tomography (CT) scans were performed on 106 pathologic discs in 92 patients.
Mean follow-up interval was 14 months.
Imaging changes were assessed and correlated with clinical results.

Main Results:

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A majority of herniations decreased in size in successfully treated patients (p < 0.0001).

Larger herniations showed a greater tendency to diminish compared to smaller ones (p < 0.0001).

Diffuse disc bulges did not regress and were associated with poor outcomes. Central herniations were less likely to diminish than those at other locations. Normal initial disc space predicted better outcomes.

Conclusions:

Herniation size reduction correlates with successful conservative treatment outcomes.
Diffuse disc bulges are poor prognostic indicators.
Initial disc space status influences treatment success.