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Spontaneous regression of a large sequestered lumbar disc herniation: a case report and literature review
Authors:Chengxiang Hu  Baocheng Lin  Zhixing Li  Xiaozhuan Chen  Kun Gao
Institution:1.Department of Joints and Soft Tissue Injury, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China; 2.Guangzhou University of Chinese Medicine, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou, China; 3.Department of Orthopaedics, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
Abstract:Lumbar disc herniation is a common disorder in adults that is accompanied by lower back and radicular pain. A 32-year-old man visited our clinic with 1-week history of persistent lower back pain and weakness in his right big toe. Magnetic resonance imaging (MRI) of his lumbar spine revealed herniated discs at L3/L4, L5/S1 and L4/L5, where a right-sided intraspinal mass lesion deep to the L4 vertebral body was causing compression of the nerve root. The patient underwent conservative treatment and reported no symptoms referrable to his back or leg 4 months later. Follow-up MRI showed no herniation of the nucleus pulposus at the L4/L5 level or lesion deep to the vertebral body of L4, whereas no changes had occurred to the status of the herniated L3/L4 and L5/S1 discs. The present case and a literature review show that a sequestered lumbar disc herniation can regress within a relatively short timeframe without surgery. The authors emphasise the utility of conservative therapy for patients who do not have a definitive surgical indication.
Keywords:Disc herniation  spontaneous regression  lower back pain  lumbar spine  intraspinal mass lesion  conservative therapy
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