Low back pain is the global leading cause of disability. Herniated intervertebral discs are a common cause of lower back pain. The natural history of the herniated intervertebral disc is that it can resorb spontaneously through an immune-mediated mechanism. Despite this favourable natural history, there is an increasing reliance on surgical intervention. A 64-year-old presented with a left L3/4 disc prolapse. With reassurance, simple analgesics, and motor control exercises, the MRI scan confirmed the complete resolution of the disc prolapse within 3 months. Patients with disc prolapses should be reassured that disc prolapses will naturally resolve and advised to remain active. Surgical intervention should only be considered with the presence of red flags, progressive neurology, or when clear evidence exists that all non-interventional techniques have been exhausted. With such a favourable natural history, caution should be exercised before surgical intervention is recommended.
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http://dx.doi.org/10.1093/jscr/rjad644 | DOI Listing |
Neurosurg Rev
January 2025
Department of Orthopedic Surgery, NHO Osaka Minami Medical Center, Kawachinagano, Osaka, Japan.
Surgery is often the treatment of choice for lumbar disc herniation (LDH) with severe leg pain. This study aimed to investigate the efficacy of Condoliase chemonucleolysis (CC) in patients who were nonambulatory because of severe leg pain. A total of 58 patients who underwent CC for conservative treatment-resistant LDH were included in this study.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
This study aims to thoroughly investigate the clinical presentation, duration of symptoms, radiological aspects of posterior epidural migration of disc fragments (PEMDF), and assess various treatment options and their impacts on patient functionality. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a comprehensive search in PubMed, Web of Science, and Scopus from inception to March 2024.
View Article and Find Full Text PDFBMC Surg
January 2025
Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, PR China.
Background: To investigate and quantify the influence of body mass index (BMI) on the efficacy and outcomes of percutaneous transforaminal endoscopic surgery (PTES), a novel minimally invasive surgical technique in the treatment of lumbar disc herniation (LDH).
Methods: A total of 55 patients suffering from single-level LDH with or without high iliac crest, scoliosis or calcification, who underwent PTES in our department from January 2019 to December 2021 were retrospectively analyzed. Patients were divided into two groups according to BMI.
BMC Musculoskelet Disord
January 2025
Department of Orthopaedics and Traumatology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey.
Background: Artcure diffusional patch (ADP) is a novel transdermal therapeutic system that started to be used in the last decade for lumbar disc herniation (LDH). Previous studies have reported early results of the therapy. In this study, we aimed to evaluate the medium- to long-term functional outcomes of this treatment in LDH patients and examine factors predicting the need for surgery after treatment.
View Article and Find Full Text PDFAnesth Pain Med (Seoul)
January 2025
Department of Anesthesia, Intensive Care and Pain Medicine, Faculty of Medicine, Alfayoum University, Alfayoum, Egypt.
Background: Epidural steroid injections are frequently used to treat chronic radicular pain of a discogenic origin; however, their efficacy remains limited. Magnesium sulfate and dexmedetomidine are emerging adjuvants with the potential to enhance the effectiveness and prolong the therapeutic duration of steroid injections.
Methods: In this randomized, double-blind study, 90 patients with unilateral lower limb radiculopathy due to lumbar disc prolapse who did not respond to conservative treatment for 12 weeks were assigned to three groups.
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