Spontaneous Regression of Lumbar Herniated Intervertebral Disc

Kil, Jin Sang; Eom, Ki Seong; Park, Jong Tae; Moon, Seong Keun; Kim, Tae Young

Abstract

Although the spontaneous regression of herniated intervertebral disc(HIVD) is well documented, the most useful and effective treatment protocol for symptomatic HIVD remains controversial. Here, we present a rare case of spon- taneous regression of lumbar HIVD. A 43-year-old woman presented with a pain in her lower back and right lower limb radiating from the buttock to the calf. Straight-leg raising test was positive at 30 degrees on the right side. Magnetic resonance imaging(MRI) revealed right-sided extrusion of an L5-S1 disc fragment with caudal migration; the disc fragment compressed the dural sac and nerve root at this level. The patient refused surgery and was, therefore, managed with conservative therapy comprising bed rest, epidural block, muscle relaxants, and nonsteroidal anti- inflammatory drugs(NSAIDs) for 45 days. At a follow-up after 45 days of this therapy, all the initial symptoms of the patient disappeared completely and a follow-up MRI showed regression of the disc fragment. The exact mecha- nism that prompted this regression is still unclear. However, as shown in our case, lumbar HIVD may spontaneously regress, implying that conservative treatment should be given additional importance in the treatment of HIVD.