SPONTANEOUS RESOLUTION OF SCIATICA IN LUMBAR DISC EXTRUSIONS
Abstract
Sciatica is a common disturbance that presents itself with an excruciating pain in the leg accompanied with paresthesia or dysesthesia along the leg which can disable patients with their everyday activities. The aim of this study is to present cases of sciatica with spontaneous resolution. We present 9 illustrative cases of patients with sciatica caused by extrusion of lumbar disc who recovered spontaneously within a year of follow-up. The patients were examined and treated in the Specialized Hospital for Orthopedic Surgery and Traumatology “St. Erazmo” in Ohrid, R. Macedonia in the period of 2018 to 2020. Eight of nine patients were suggested to be treated by surgery because of the symptoms of sciatica and the magnetic resonance findings of the lumbar spine, but they refused. The cases present patients with sciatica caused by lumbar disc extrusion which resolved spontaneously without surgery. Patients should be indicated for magnetic resonance imaging for precise indications, not only for acute onset of leg pain caused by sciatica. Conservative treatment should be considered as an option for treatment of sciatica.
Key words: spontaneous resolution, sciatica, extrusion
References
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21.Splendaini A, Puglielli E, De Amicis R, et al. Spontaneous resolution of lumbar disc herniations: predictive signs for prognostic evaluation. Neuroradiology. 2004: 46:916-922.
22.Autio RA, Karppinen J, Niinimaki J, et al. Determinants of spontaneous resorption of intervertebral disc herniations. Spine (Phila Pa 1976). 2006: 31:1247-1252.
23.Henmi T, Sairyo K, Nakano S, et al. Natural history of extruded lumbar intervertebral disc herniations. J Med Invest. 2002: 49:40-43.
24.Takada E, Takahashi M and Shimada K. Natural history of lumbar disc hernia with radicular leg pain: Spontaneous MRI changes of the herniated mass and correlation with clinical outcome. J Orthop Surg (Hong Kong). 2001: 9:1-9.
25.Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine. 1983: 8(2):131-140.
26.Atlas SJ, Keller RB, Chang Y, Deyo RA, Singer DE. Surgical and nonsurgical management of sciatica secondary to lumbar disc herniation: five-year outcome from the Maine Lumbar Spine Study. Spine. 2001: 26(10):1179-1187.
27.Saal JA, Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. Spine. 1989: 14(4):431-437.
28.Orief T, Orz Y, Attia W, Almusrea K. Spontaneous resorptionof sequestrated intervertebral disc herniation. World Neurosurg. 2012: 77(1):146-152.
29.Rothoerl RD, Woertgen C, Brawanski A. When should conservative treatment for lumbar disc herniation be ceased and surgery considered? Neurosurg Rev. 2002: 25(3):162-165.
2.Delen E, Coskun T. Spontaneous regression in herniated lumbar disc: Mechanism and Prognostic factors. Sch. J. App. Med. Sci., 2015; 3(5B): 1918-1921.
3.Sabuncuoglu H, Ozdogan S, Timurkaynak. Spontaneous regression of extruded lumbar disc herniation: Report of two illustrative case and review of theliterature. Turkish Neurosurgery. 2008; Vol:18, No:4, 392-396.
4.Bozzao A, Gallucci M, Masciocchi C, Aprile I, Barile A, Passariello R. Lumbar disc herniation: MR imaging assessment of natural history in patients treated without surgery. Radiology. 1992: 185(1):135-141
5.Borota L, Jonasson P, Agolli A. Spontaneous resorption of intradural lumbar disc fragments. Spine J. 2008: (2):397-403.
6.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(10):1205-1212.
7.Fager CA. Observations on spontaneous recovery from intervertebral disc herniation. Surg Neurol. 1994: 42(2):282-286.
8.Maigne JY, Deligne L. Computed tomographic follow-up study of 21 cases of nonoperatively treated cervical intervertebral soft disc herniation. Spine. 1994: 19(2):189-191.
9.Reyentovich A, Abdu WA. Multiple independent, sequential, and spontaneously resolving lumbar intervertebral disc herniations: A case report. Spine. 2002: 27(5):549-553.
10.Saal JA, Saal JS, Herzog RJ. The natural history of lumbar intervertebral disc extrusions treated nonoperatively. Spine. 1990: 15(7):668-683.
11.Slavin KV, Raja A, Thornton J, Wagner FC Jr. Spontaneous regression of a large lumbar disc herniation: Report of an illustrative case. Surg Neurol. 2001: 56(5):333-336.
12.Komori H, Shinomiya K, Nakai O, Yamaura I, Takeda S, Furuya K. The natural history of herniated nucleus pulposus with radiculopathy. Spine. 1996: 15;21(2)225-229.
13. Weinstein JN, Lurie JD, Tosteson TD. Surgical vs nonoperative treatment for lumbar disc herniation: the Spine Patient Outcomes Research Trial (SPORT) observational. Cohort JAMA. 2006: 296(20):2451-2459.
14.Teplick JG, Haskin ME. Spontaneous regression of herniated nucleus pulposus. AJR Am J Roentgenol. 1985: 145(2):371-375.
15.Ellenberg M, Reina N, Ross M, Chodoroff G, Honet JC, Gross N. Regression of herniated nucleus pulposus: two patients with lumbar radiculopathy. Arch Phys Med Rehabil. 1989: 70(12):842-844.
16.Guinto FC Jr, Hashim H, Stumer M. CT demonstration of disc regression after conservative treatment. AJNR Am J Neuroradiol. 1984: 5(5):632-633.
17.Djuric N, Yang X, el Barzouhi A, Ostelo R, van Duinen G, Lycklama a Nijeholt J, van der Kallen BFW, Peul WC, Vleggeert-Lankamp CLA. Lumbar disc extrusions reduce faster than bulging discs due to an active role of macrophages in sciatica. Acta Neurochir (Wien). 2020: 162(1):79-85.
18.Chiu CC, Chuang TY, Chang KH, Wu CH, Lin PW, Hsu WY. The probability of spontaneous regression of lumbar herniated disc: a systemic review. Clin Rehabil. 2015 Feb: 29(2): 184-195.
19.Komori H, Okawa A, Haro H, et al. Contrast-enhanced magnetic resonance imaging in conservative management of lumbar disc herniation. Spine (Phila Pa 1976). 1998: 23:67-73.
20.Matsubara Y, Kato F, Mimatsu K, et al. Serial changes on MRI in lumbar disc herniations treated conservatively. Neuroradiology. 1995: 37:378-383.
21.Splendaini A, Puglielli E, De Amicis R, et al. Spontaneous resolution of lumbar disc herniations: predictive signs for prognostic evaluation. Neuroradiology. 2004: 46:916-922.
22.Autio RA, Karppinen J, Niinimaki J, et al. Determinants of spontaneous resorption of intervertebral disc herniations. Spine (Phila Pa 1976). 2006: 31:1247-1252.
23.Henmi T, Sairyo K, Nakano S, et al. Natural history of extruded lumbar intervertebral disc herniations. J Med Invest. 2002: 49:40-43.
24.Takada E, Takahashi M and Shimada K. Natural history of lumbar disc hernia with radicular leg pain: Spontaneous MRI changes of the herniated mass and correlation with clinical outcome. J Orthop Surg (Hong Kong). 2001: 9:1-9.
25.Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine. 1983: 8(2):131-140.
26.Atlas SJ, Keller RB, Chang Y, Deyo RA, Singer DE. Surgical and nonsurgical management of sciatica secondary to lumbar disc herniation: five-year outcome from the Maine Lumbar Spine Study. Spine. 2001: 26(10):1179-1187.
27.Saal JA, Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. Spine. 1989: 14(4):431-437.
28.Orief T, Orz Y, Attia W, Almusrea K. Spontaneous resorptionof sequestrated intervertebral disc herniation. World Neurosurg. 2012: 77(1):146-152.
29.Rothoerl RD, Woertgen C, Brawanski A. When should conservative treatment for lumbar disc herniation be ceased and surgery considered? Neurosurg Rev. 2002: 25(3):162-165.
Published
2020-12-28
How to Cite
MICUNOVIC, Micun Mile et al.
SPONTANEOUS RESOLUTION OF SCIATICA IN LUMBAR DISC EXTRUSIONS.
Journal of Morphological Sciences, [S.l.], v. 3, n. 3, p. 79-92, dec. 2020.
ISSN 2545-4706.
Available at: <http://jms.mk/jms/article/view/163>. Date accessed: 19 apr. 2024.
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