SPONTANEOUS REGRESSION OF LUMBAR DISC HERNIATIONS

Abstract

Objective: Lower back and back pain are among the most common disease symptoms. On the other hand, herniated nucleus pulposus (HNP) is a common condition that triggers radiculopathy or myelopathy. If radiculopathy affecting the foot occurs concurrently with back pain, the patient is very likely to have lumbar disc herniation. Medical treatment, bed rest and physical therapy are primarily recommended to patients with radicular pain. This study aimed to describe the factors associated with spontaneous disc regression. Materials and Methods: Patients who were admitted to the outpatient clinic with lower back and leg pain were closely followed-up. After magnetic resonance imaging (MRI) scans revealed lumbar (HNP), a conservative medical treatment was recommended. When the patients' radicular pain disappeared or neurological exams became normal, control MRI scans were done. Then, we retrospectively reviewed these patients. Results: We detected a total of 12 patients with lumbar disc regression, including six males and six females, in the last 3 years of follow-up. The mean age of the patients was 41.83±6.83. LHNP was present at the L4-5 space in five patients and at the L5-S1 space in seven patients. Eight (62.5%) of the patients had sequestrated disc herniation, while four had subligamentous disc herniation. Four of the sequestrated discs were upmigrated, and four of them were down-migrated. The mean time to pain disappearance of the patients was 2.33±1.23 months. Conclusion: A conservative treatment and bedrest are primarily recommended to patients with lumbar disc herniation and pain complaints. Time should be given for the body to regress the lumbar disc herniation with an inflammatory response. Surgery is inevitable in cases of unbearable pain and emergency conditions.