Vertebral Disc Problems - Bulge, Herniation, Extrusion - Slip Disc - Sciatica

 

The probability of spontaneous regression of lumbar herniated disc: a systematic review

Review Clin Rehabil

. 2015 Feb;29(2):184-95. doi: 10.1177/0269215514540919. 

Results: The rate of spontaneous regression was found to be 96% for disc sequestration, 70% for disc extrusion, 41% for disc protrusion, and 13% for disc bulging. The rate of complete resolution of disc herniation was 43% for sequestrated discs and 15% for extruded discs.

Conclusions: Spontaneous regression of herniated disc tissue can occur, and can completely resolve after conservative treatment. Patients with disc extrusion and sequestration had a significantly higher possibility of having spontaneous regression than did those with bulging or protruding discs. Disc sequestration had a significantly higher rate of complete regression than did disc extrusion.

https://pubmed.ncbi.nlm.nih.gov/25009200/

Bush et al. studied 165 patients with sciatica thought to be due to lumbosacral nerve root compromise. They were treated with serial epidurals. Of the study cohort, 14% underwent surgical decompression and the rest made satisfactory clinical recovery. They were surprised to find on follow-up CT scanning that 64 of the 84 herniated/sequestered intervertebral discs showed partial or complete resolution at 1 year, whereas only 7 of the 27 bulging discs showed any resolution at 1 year. This was statistically significant.

Bush K, Cowan N, Katz DE, Gishen P. The natural history of sciatica associated with disc pathology. A prospective study with clinical and independent radiologic follow-up. Spine 1992; 17: 1205–12.

Research Article

Published Online March 2010

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Conservatively treated massive prolapsed discs: a 7-year follow-up

Authors: RT Benson, SP Tavares, SC Robertson, R Sharp, and RW Marshall

ublication: The Annals of The Royal College of Surgeons of England

Volume 92, Number 2

Published Online March 2010

Conclusions

We can answer the questions that were posed at the outset of our study:

1.

It is safe to adopt a ‘wait-and-watch’ policy for cases of massive disc herniation if there is any early sign of clinical improvement.

2.

Where clinical progress is evident, 83% of cases of massive disc herniation will have sustained improvement.

3.

Only 17% of cases will have recurring crises of back pain and sciatica.

4.

If there is evidence of clinical improvement, massive disc prolapses do not appear to carry a risk of major nerve damage or cauda equina syndrome.

5.

Massive disc herniations usually reduce in volume and by 6 months most are only a third of their original size.

https://publishing.rcseng.ac.uk/doi/10.1308/003588410X12518836438840

Bulge - Herniation L5-S1

Detailed article

https://discseel.com/herniated-disc-l5-s1/