Yonsei Med J.  2002 Jun;43(3):283-290. 10.3349/ymj.2002.43.3.283.

Comparison of Clinical Outcomes and Natural Morphologic Changes between Sequestered and Large Central Extruded Disc Herniations

Affiliations
  • 1Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Korea. shahn@med.yu.ac.kr
  • 2Department of Diagnostic Radiology, College of Medicine, Yeungnam University, Daegu, Korea.
  • 3Department of Orthopedic Surgery, College of Medicine, Yeungnam University, Daegu, Korea.
  • 4Department of Neurological Surgery, College of Medicine, Yeungnam University, Daegu, Korea.

Abstract

A prospective and longitudinal investigation concerning clinical outcomes and morphologic changes of large lumbar disc herniations by MR imaging. To compare the clinical outcomes and the natural morphologic changes of between sequestered and large central extruded disc herniations. The spontaneous disappearance or diminution of large herniated lumbar discs in the spinal canal is known. Poor clinical outcome and small changes of herniated discs have been shown for large central extruded disc herniations with conservative treatment. The study population consisted of 22 patients with sequestration and a large central as extrusion established by an MR imaging study. Seventeen (11 patients with sequestration, and 6 patients with a large central extrusion) patients underwent a follow-up MR imaging study. The size of the herniated disc was measured on serial MR imaging studies, and the changes in size were classified into four categories. Clinical evaluations were also performed using a visual analogue scale (VAS), the Oswestry lowback pain disability questionnaire, the straight leg raising test (SLRT) and so forth. Both the sequestered and large central extruded disc herniations showed a successful clinical outcome after conservative treatment in 17 of 22 patients (77%) in total: 11 of 13 patients (85%) with sequestered disc herniations, and 6 of 9 patients (67%) with large central extruded disc herniations. VAS and Oswestry disability scoring showed a greater change in the group with sequestration than in the group with large central extrusions. In the group with sequestration, seven patients reported the disappearance of herniated disc materials, and four patients showed a marked decrease in the size of their herniated discs in follow-up MR images. However, in the group with large central extrusions, only two patients showed a decrease in the size of their herniated discs. Large central extruded disc herniations can be treated successfully by conservative treatment. Outcomes seemed to be as good as or slightly inferior to those of sequestered disc herniations. However, a greater morphologic decrease in the herniated discs occurred more frequently for sequestered disc herniations than for large central extruded disc herniations.

Keyword

Sequestered disc; large central extruded disc; conservative treatment; magnetic resonance imaging

MeSH Terms

Adult
Aged
Comparative Study
Female
Human
Intervertebral Disk Displacement/*diagnosis/*therapy
Longitudinal Studies
*Magnetic Resonance Imaging
Male
Middle Age
Prospective Studies
Treatment Outcome

Cited by  2 articles

Effectiveness of Selective Nerve Root Block on the Need for Surgical Treatment of Lumbar Disc Herniation
Dae Moo Shim, Jin Young Park, Jung Hwan Yang, Byong San Choi
J Korean Orthop Assoc. 2008;43(4):413-419.    doi: 10.4055/jkoa.2008.43.4.413.

The Usefulness of Selective Nerve Root Block as a Predictor of Prognosis of Lumbar Disc Herniation
Dong-Ho Lee, Min Seok Kim, Kang-Sup Yoon, Seung-Baik Kang, Hyuh Chul Jo, Kun-Woo Park, Kwang Sup Song, Jin Sup Yeom, Bong-Soon Chang, Choon-Ki Lee, Ji-Ho Lee
J Korean Soc Spine Surg. 2005;12(3):192-199.    doi: 10.4184/jkss.2005.12.3.192.

Full Text Links
  • YMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr