Posted By: Kevin G. Parker, D.C.
Full article on Pubmed.gov: Ann R Coll Surg Engl. 2010
Conservatively treated massive prolapsed discs: a 7-year follow-up
RT Benson, SP Tavares, SC Robertson, R Sharp, and RW Marshall
[Side note from me…Patients often ask what happens to the herniated lumbar disc material over time. This study provides a bit more insight.]
Conclusion: A massive disc herniation can pursue a favorable clinical course.
If early progress is shown, the long-term prognosis is very good and even massive disc herniations can be treated conservatively.
Abstract
INTRODUCTION
The natural history of a lumbar hernia of the nucleus pulposus (HNP) is not fully known and clear indications for operative intervention cannot be established from the literature. Several studies have shown that the largest discs appear to have the greatest tendency to resolve. The aim of this study was to investigate whether massive prolapsed discs can be safely managed conservatively once clinical improvement has occurred.
PATIENTS AND METHODS
Thirty-seven patients were studied by clinical assessments and serial magnetic resonance imaging (MRI) over 2 years. Patients had severe sciatica at first, but began to show clinical improvement despite the large disc hernia-tions. Clinical assessment included the Lasegue test and neurological appraisal. The Oswestry Disability Index was used to measure function and changes in function. Serial MRI studies allowed measurement of volume changes of the herniated disc material over a period of time.
RESULTS
Initial follow-up at an average of 23.2 months revealed that 83% had a complete and sustained recovery at the initial follow-up. Only four patients required a discectomy. The average Oswestry disability index improved from 58% to 15%. Volumetric analysis of serial MRI scans found an average reduction of 64% in disc size. There was a poor correlation between clinical improvement and the extent of disc resolution.
***references below…
Other good reads
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A New Gatekeeper for Back Pain
Fish oil-Neurosurgeon for the Pittsburgh Steelers
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Gluten Free Diet helped Nerve Pain-Neurology 2010
Inflammation-13 Tips To Fight Inflammation
Laser Therapy in Rehabilitation-Irvine California
Muscle Trigger points vs Acupuncture points
Neck pain-Journal of the American Board of Family Practice 2004
Nerve ingrowth into chronic painful disc-Lancet 1997
Nerve Supply of the lumbar disc-JBJS 2007
Omega 3’s-Molecular Neurobiology-January 2011
Omega 3′s and Nerve pain-Clinical Journal of Pain 2010
Sitting-Can sitting too much kill you? Scientific American Jan 2011
Vit. D-What We Have Learned About Vitamin D Dosing
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