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.
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.
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.
Other good reads
Spinal Decompression Case Study (Case Study: 12mm Herniated Disc with Extrusion with Pre- and Post-Spinal Decompression MRI Images) from our office with Before and After MRIs.
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If you are suffering from: Sports Injuries, Sprains, Strains, Car accident, Herniated Disc, Disc Bulge, Degenerative Disc Disease, Neck pain, Headaches, Low back pain, of just want to feel better and have better life performance– please call our office in Irvine, California- at 949.857.1888or visit our website at ADJUST2IT to learn more about Functional Fitness Chiropractic, Sports massage, Myofascial Release, Corrective Exercise, Non Surgical Spinal Decompression, Class IV laser, Functional Endocrinology and Functional Nutrition.