Spontaneously disappearing large herniated lumbar disc fragment

Umamaheswara V. Reddy; Amit Agrawal; Kishor V. Hegde; P. Suneetha; Malleswara G. Rao

doi:10.4103/2319-2585.134208

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Case Report

2 (

); 26-28

doi:

10.4103/2319-2585.134208

Spontaneously disappearing large herniated lumbar disc fragment

Umamaheswara V. Reddy, Amit Agrawal^1,, Kishor V. Hegde, P. Suneetha, Malleswara G. Rao¹

Department of Radiology, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India

1Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India

Address for correspondence: Dr. Amit Agrawal, Professor of Neurosurgery, Department of Neurosurgery, Narayna Medical College Hospital, Chinthareddypalem, Nellore 524 003, Andhra Pradesh, India. E-mail: dramitagrawal@gmail.com

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This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.

How to cite this article: Reddy UV, Agrawal A, Hegde KV, Suneetha P, Rao MG. Spontaneously disappearing large herniated lumbar disc fragment. J Orthop Allied Sci 2014;2:26-8.

Abstract

There are reports of spontaneous regression of large extruded disc; however, the exact underlying mechanism and management of such cases remains controversial. We report a 40-year-old female who opted for conservative management for a large extruded lumbar disc. Follow-up magnetic resonance imaging (MRI) showed complete disappearance of the disc fragment; however, there were degenerative changes in the upper and lower adjacent margins of the vertebral body. Spine surgeons should be aware of spontaneous regression of the disc phenomenon as a patient with a large extruded disc who opted for the conservative management initially can have persistence pain, but there may not be an underlying protruded disc.

Keywords

Disappearing disc

herniation

lumbar disc

regression disc

spontaneous regression

Show Related Articles from PubMed

Introduction

Herniated lumbar disc is one of the common causes of low back pain and smaller disc herniations tend to regress over a period of time; and thus, the pain is known to improve with conservative management.^[1,2,3,4,5] There are reports of spontaneous regression of large extruded disc; however, the exact underlying mechanism and management of such cases remains controversial.^{[4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19]}

Case Report

A 40-year-old female presented with low back pain of 2 year duration. The pain was radiating to lower limbs more to the left side. There was no history of motor or sensory deficits. There was no history of bowel or bladder dysfunction. She was investigated for the similar problem with an MRI 6 months back and it showed a large disc protrusion [Figure 1]. However, she opted for conservative management. On examination, there were no focal motor or sensory deficits. Deep tendon reflexes were normal except bilateral sluggish ankle jerks. Planters were flexor. As the patient was complaining in the severity of the pain with numbness and a repeat magnetic resonance imaging (MRI) was performed. Follow-up MRI showed complete disappearance of the disc fragment; however, there were degenerative changes in the upper and lower adjacent margins of the vertebral body [Figure 2].

Magnetic resonance imaging T1-weighted and T2W sagittal images and fluid-attenuated inversion recovery axial image showing a large extruded disc at L4– 5 level more on the right side with compression of the thecal sac

Follow-up MRI T2W sagittal images at 6 months showing complete disappearance of the extruded disc with Modic changes in the lower end plate of L4 and upper end plate of L5 vertebral body

Discussion

Spontaneous regression of herniated disc material was first documented in 1984;^[20,21] and since then, many authors have reported reduction in the size of herniated disc material on follow-up images with conservative treatment.^{[4,11,12,13,21,22,23,24]} The exact timing for spontaneous regression of the protruded disc material is not known; however, it ranges from few weeks to months.^{[5,10,11,17,21,22,25,26,27]} The fastest regression of the fragmented disc material was reported in 2 months.^[8] Many hypotheses have been proposed to explain the regression of the disc material including retraction of the herniated disc material, dehydration of herniated disc material, and inflammatory reaction and neovascularization.^{[10,18,20,28,29]} Inflammatory reaction and neovascularization is the widely accepted hypothesis where the extruded disc material is recognized as a foreign body inducing an inflammatory reaction and followed by removal of the disc material.^{[10,20,28,29,30,31,32,33,34,35,36,37]}

Conclusion

Present case illustrates that a conservative approach can be adopted for a large extruded lumbar disc as it can resolve in a selective group of patients.^[24,38,39] Spine surgeons should be aware of spontaneous regression of the disc phenomenon as a patient with a large extruded disc who opted for the conservative management initially can have persistence pain, but there may not be an underlying protruded disc. It is important to perform a repeat imaging of the spine to assess the degree and severity of the disc protrusion before making a plan for surgery or any further conservative management.

Source of Support:

Nil

Conflict of Interest:

None declared.

REFERENCES

Hakelius A. Prognosis in sciatica. A clinical follow-up of surgical and non-surgical treatment. Acta Orthop Scand Suppl. 1970;129:1-76.
[CrossRef] [PubMed] [Google Scholar]
Saal JA, , Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. Spine. 1989;14:431-7.
[CrossRef] [PubMed] [Google Scholar]
Saal JA. Natural history and nonoperative treatment of lumbar disc herniation. Spine. 1996;21:2S-9S.
[CrossRef] [PubMed] [Google Scholar]
Saal JA, , Saal JS, , Herzog RJ. The natural history of lumbar intervertebral disc extrusions treated nonoperatively. Spine. 1990;15:683-6.
[CrossRef] [PubMed] [Google Scholar]
Sei A, , Nakamura T, , Fukuyama S, , Ikeda T, , Senda H, , Takagi K. [Spontaneous regression of lumbar hernia of the nucleus pulposus. Follow-up study of 4 cases by repeated magnetic resonance imaging] Rev Chir Orthop Reparatrice Appar Mot. 1994;80:144-9.
[Google Scholar]
Postacchini F. Results of surgery compared with conservative management for lumbar disc herniations. Spine. 1996;21:1383-7.
[CrossRef] [PubMed] [Google Scholar]
Ahn SH, , Ahn MW, , Byun WM. Effect of the transligamentous extension of lumbar disc herniations on their regression and the clinical outcome of sciatica. Spine. 2000;25:475-80.
[CrossRef] [PubMed] [Google Scholar]
Bozzao A, , Gallucci M, , Masciocchi C, , Aprile I, , Barile A, , Passariello R. Lumbar disk herniation: MR imaging assessment of natural history in patients treated without surgery. Radiology. 1992;185:135-41.
[CrossRef] [PubMed] [Google Scholar]
Delauche-Cavallier MC, , Budet C, , Laredo JD, , Debie B, , Wybier M, , Dorfmann H, , et al. Lumbar disc herniation. Computed tomography scan changes after conservative treatment of nerve root compression. Spine. 1992;17:927-33.
[CrossRef] [PubMed] [Google Scholar]
Komori H, , Shinomiya K, , Nakai O, , Yamaura I, , Takeda S, , Furuya K. The natural history of herniated nucleus pulposus with radiculopathy. Spine. 1996;21:225-9.
[CrossRef] [PubMed] [Google Scholar]
Matsubara Y, , Kato F, , Mimatsu K, , Kajino G, , Nakamura S, , Nitta H. Serial changes on MRI in lumbar disc herniations treated conservatively. Neuroradiology. 1995;37:378-83.
[CrossRef] [PubMed] [Google Scholar]
Modic MT, , Ross JS, , Obuchowski NA, , Browning KH, , Cianflocco AJ, , Mazanec DJ. Contrast-enhanced MR imaging in acute lumbar radiculopathy: A pilot study of the natural history. Radiology. 1995;195:429-35.
[CrossRef] [PubMed] [Google Scholar]
Cribb GL, , Jaffray DC, , Cassar-Pullicino VN. Observations on the natural history of massive lumbar disc herniation. J Bone Joint Surg Br. 2007;89:782-4.
[CrossRef] [PubMed] [Google Scholar]
Lapuyade G, , Loustau JM. [Spontaneous regression of disk herniation. Apropos of 7 cases] J Radiol. 1989;70:697-702.
[Google Scholar]
Ellenberg M, , Reina N, , Ross M, , Chodoroff G, , Honet JC, , Gross N. Regression of herniated nucleus pulposus: Two patients with lumbar radiculopathy. Arc Phys Med Rehabil. 1989;70:842-4.
[Google Scholar]
Keskil S, , Ayberk G, , Evliyaoðlu C, , Kizartici T, , Yücel E, , Anbarci H. Spontaneous resolution of "protruded" lumbar discs. Minim Invasive Neurosurg. 2004;47:226-9.
[CrossRef] [PubMed] [Google Scholar]
Ushewokunze S, , Abbas N, , Dardis R, , Killeen I. Spontaneously disappearing lumbar disc protrusion. Br J Gen Pract. 2008;58:646-7.
[CrossRef] [PubMed] [Google Scholar]
Ryu SJ, , Kim IS. Spontaneous regression of a large lumbar disc extrusion. J Korean Neurosurg Soc. 2010;48:285-7.
[CrossRef] [PubMed] [Google Scholar]
Kil JS, , Eom KS, , Park JT, , Moon SK, , Kim TY. Spontaneous regression of lumbar herniated intervertebral disc. Korean J Spine. 2010;7:34-6.
[Google Scholar]
Guinto FC, , Hashim H, , Stumer M. CT demonstration of disk regression after conservative therapy. AJNR Am J Neuroradiol. 1984;5:632-3.
[Google Scholar]
Teplick JG, , Haskin ME. Spontaneous regression of herniated nucleus pulposus. AJR Am J Roentgenol. 1985;145:371-5.
[CrossRef] [PubMed] [Google Scholar]
Masui T, , Yukawa Y, , Nakamura S, , Kajino G, , Matsubara Y, , Kato F, , et al. Natural history of patients with lumbar disc herniation observed by magnetic resonance imaging for minimum 7 years. J Spinal Disord Tech. 2005;18:121-6.
[CrossRef] [PubMed] [Google Scholar]
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;17:1205-12.
[CrossRef] [PubMed] [Google Scholar]
Benson RT, , Tavares SP, , Robertson SC, , Sharp R, , Marshall RW. Conservatively treated massive prolapsed discs: A 7-year follow-up. Ann R Coll Surg Engl. 2010;92:147-53.
[CrossRef] [PubMed] [Google Scholar]
Autio RA, , Karppinen J, , Niinimäki J, , Ojala R, , Kurunlahti M, , Haapea M, , et al. Determinants of spontaneous resorption of intervertebral disc herniations. Spine (Phila Pa 1976). 2006;31:1247-52.
[CrossRef] [PubMed] [Google Scholar]
Takada E, , Takahashi M, , 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;9:1-7.
[CrossRef] [PubMed] [Google Scholar]
Miller S, , Casden AM. Spontaneous regression of a herniated disk. A case report with a four year follow-up. Bull Hosp Jt Dis. 1998;57:99-101.
[Google Scholar]
Benoist M. The natural history of lumbar degenerative spinal stenosis. Joint Bone Spine. 2002;69:450-7.
[CrossRef] [PubMed] [Google Scholar]
Slavin KV, , Raja A, , Thornton J, , Wagner FC. Spontaneous regression of a large lumbar disc herniation: Report of an illustrative case. Surg Neurol. 2001;56:333-336.
[CrossRef] [PubMed] [Google Scholar]
Satoh K, , Konno S, , Nishiyama K, , Olmarker K, , Kikuchi S. Presence and distribution of antigen-antibody complexes in the herniated nucleus pulposus. Spine. 1999;24:1980-4.
[CrossRef] [PubMed] [Google Scholar]
Grönblad M, , Virri J, , Seitsalo S, , Habtemariam A, , Karaharju E. Inflammatory cells, motor weakness, and straight leg raising in transligamentous disc herniations. Spine. 2000;25:2803-7.
[CrossRef] [PubMed] [Google Scholar]
Grönblad M, , Virri J, , Tolonen J, , Seitsalo S, , Kääpä E, , Kankare J, , et al. A controlled immunohistochemical study of inflammatory cells in disc herniation tissue. Spine. 1994;19:2744-51.
[CrossRef] [PubMed] [Google Scholar]
Ito T, , Yamada M, , Ikuta F, , Fukuda T, , Hoshi SI, , Kawaji Y, , et al. Histologic evidence of absorption of sequestration-type herniated disc. Spine. 1996;21:230-4.
[CrossRef] [PubMed] [Google Scholar]
Haro H, , Crawford HC, , Fingleton B, , MacDougall JR, , Shinomiya K, , Spengler DM, , et al. Matrix metalloproteinase-3-dependent generation of a macrophage chemoattractant in a model of herniated disc resorption. J Clin Invest. 2000;105:133-41.
[CrossRef] [PubMed] [Google Scholar]
Haro H, , Komori H, , Kato T, , Hara Y, , Tagawa M, , Shinomiya K, , et al. Experimental studies on the effects of recombinant human matrix metalloproteinases on herniated disc tissues-how to facilitate the natural resorption process of herniated discs. J Orthop Res. 2005;23:412-9.
[CrossRef] [PubMed] [Google Scholar]
Marshall LL, , Trethewie ER, , Curtain CC. Chemical radiculitis. A clinical, physiological and immunological study. Clin Orthop Relat Res. 1977;129:61-7.
[CrossRef] [Google Scholar]
Modic MT, , Masaryk T, , Paushter D. Magnetic resonance imaging of the spine. Radiol Clin North Am. 1986;24:229..
[CrossRef] [PubMed] [Google Scholar]
Atlas SJ, , Keller RB, , Chang Y, , Deyo RA, , Singer DE. Surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: Five-year outcomes from the Maine Lumbar Spine Study. Spine. 2001;26:1179-87.
[CrossRef] [PubMed] [Google Scholar]
Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine. 1983;8:131-40.
[CrossRef] [Google Scholar]

Introduction

Case Report

Discussion

Conclusion

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[1] Hakelius A. Prognosis in sciatica. A clinical follow-up of surgical and non-surgical treatment. Acta Orthop Scand Suppl. 1970;129:1-76.
[CrossRef] [PubMed] [Google Scholar]

[2] Saal JA, , Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. Spine. 1989;14:431-7.
[CrossRef] [PubMed] [Google Scholar]

[3] Saal JA. Natural history and nonoperative treatment of lumbar disc herniation. Spine. 1996;21:2S-9S.
[CrossRef] [PubMed] [Google Scholar]

[4] Saal JA, , Saal JS, , Herzog RJ. The natural history of lumbar intervertebral disc extrusions treated nonoperatively. Spine. 1990;15:683-6.
[CrossRef] [PubMed] [Google Scholar]

[5] Sei A, , Nakamura T, , Fukuyama S, , Ikeda T, , Senda H, , Takagi K. [Spontaneous regression of lumbar hernia of the nucleus pulposus. Follow-up study of 4 cases by repeated magnetic resonance imaging] Rev Chir Orthop Reparatrice Appar Mot. 1994;80:144-9.
[Google Scholar]

[6] Postacchini F. Results of surgery compared with conservative management for lumbar disc herniations. Spine. 1996;21:1383-7.
[CrossRef] [PubMed] [Google Scholar]

[7] Ahn SH, , Ahn MW, , Byun WM. Effect of the transligamentous extension of lumbar disc herniations on their regression and the clinical outcome of sciatica. Spine. 2000;25:475-80.
[CrossRef] [PubMed] [Google Scholar]

[8] Bozzao A, , Gallucci M, , Masciocchi C, , Aprile I, , Barile A, , Passariello R. Lumbar disk herniation: MR imaging assessment of natural history in patients treated without surgery. Radiology. 1992;185:135-41.
[CrossRef] [PubMed] [Google Scholar]

[9] Delauche-Cavallier MC, , Budet C, , Laredo JD, , Debie B, , Wybier M, , Dorfmann H, , et al. Lumbar disc herniation. Computed tomography scan changes after conservative treatment of nerve root compression. Spine. 1992;17:927-33.
[CrossRef] [PubMed] [Google Scholar]

[10] Komori H, , Shinomiya K, , Nakai O, , Yamaura I, , Takeda S, , Furuya K. The natural history of herniated nucleus pulposus with radiculopathy. Spine. 1996;21:225-9.
[CrossRef] [PubMed] [Google Scholar]

[11] Matsubara Y, , Kato F, , Mimatsu K, , Kajino G, , Nakamura S, , Nitta H. Serial changes on MRI in lumbar disc herniations treated conservatively. Neuroradiology. 1995;37:378-83.
[CrossRef] [PubMed] [Google Scholar]

[12] Modic MT, , Ross JS, , Obuchowski NA, , Browning KH, , Cianflocco AJ, , Mazanec DJ. Contrast-enhanced MR imaging in acute lumbar radiculopathy: A pilot study of the natural history. Radiology. 1995;195:429-35.
[CrossRef] [PubMed] [Google Scholar]

[13] Cribb GL, , Jaffray DC, , Cassar-Pullicino VN. Observations on the natural history of massive lumbar disc herniation. J Bone Joint Surg Br. 2007;89:782-4.
[CrossRef] [PubMed] [Google Scholar]

[14] Lapuyade G, , Loustau JM. [Spontaneous regression of disk herniation. Apropos of 7 cases] J Radiol. 1989;70:697-702.
[Google Scholar]

[15] Ellenberg M, , Reina N, , Ross M, , Chodoroff G, , Honet JC, , Gross N. Regression of herniated nucleus pulposus: Two patients with lumbar radiculopathy. Arc Phys Med Rehabil. 1989;70:842-4.
[Google Scholar]

[16] Keskil S, , Ayberk G, , Evliyaoðlu C, , Kizartici T, , Yücel E, , Anbarci H. Spontaneous resolution of "protruded" lumbar discs. Minim Invasive Neurosurg. 2004;47:226-9.
[CrossRef] [PubMed] [Google Scholar]

[17] Ushewokunze S, , Abbas N, , Dardis R, , Killeen I. Spontaneously disappearing lumbar disc protrusion. Br J Gen Pract. 2008;58:646-7.
[CrossRef] [PubMed] [Google Scholar]

[18] Ryu SJ, , Kim IS. Spontaneous regression of a large lumbar disc extrusion. J Korean Neurosurg Soc. 2010;48:285-7.
[CrossRef] [PubMed] [Google Scholar]

[19] Kil JS, , Eom KS, , Park JT, , Moon SK, , Kim TY. Spontaneous regression of lumbar herniated intervertebral disc. Korean J Spine. 2010;7:34-6.
[Google Scholar]

[20] Guinto FC, , Hashim H, , Stumer M. CT demonstration of disk regression after conservative therapy. AJNR Am J Neuroradiol. 1984;5:632-3.
[Google Scholar]

[21] Teplick JG, , Haskin ME. Spontaneous regression of herniated nucleus pulposus. AJR Am J Roentgenol. 1985;145:371-5.
[CrossRef] [PubMed] [Google Scholar]

[22] Masui T, , Yukawa Y, , Nakamura S, , Kajino G, , Matsubara Y, , Kato F, , et al. Natural history of patients with lumbar disc herniation observed by magnetic resonance imaging for minimum 7 years. J Spinal Disord Tech. 2005;18:121-6.
[CrossRef] [PubMed] [Google Scholar]

[23] 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;17:1205-12.
[CrossRef] [PubMed] [Google Scholar]

[24] Benson RT, , Tavares SP, , Robertson SC, , Sharp R, , Marshall RW. Conservatively treated massive prolapsed discs: A 7-year follow-up. Ann R Coll Surg Engl. 2010;92:147-53.
[CrossRef] [PubMed] [Google Scholar]

[25] Autio RA, , Karppinen J, , Niinimäki J, , Ojala R, , Kurunlahti M, , Haapea M, , et al. Determinants of spontaneous resorption of intervertebral disc herniations. Spine (Phila Pa 1976). 2006;31:1247-52.
[CrossRef] [PubMed] [Google Scholar]

[26] Takada E, , Takahashi M, , 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;9:1-7.
[CrossRef] [PubMed] [Google Scholar]

[27] Miller S, , Casden AM. Spontaneous regression of a herniated disk. A case report with a four year follow-up. Bull Hosp Jt Dis. 1998;57:99-101.
[Google Scholar]

[28] Benoist M. The natural history of lumbar degenerative spinal stenosis. Joint Bone Spine. 2002;69:450-7.
[CrossRef] [PubMed] [Google Scholar]

[29] Slavin KV, , Raja A, , Thornton J, , Wagner FC. Spontaneous regression of a large lumbar disc herniation: Report of an illustrative case. Surg Neurol. 2001;56:333-336.
[CrossRef] [PubMed] [Google Scholar]

[30] Satoh K, , Konno S, , Nishiyama K, , Olmarker K, , Kikuchi S. Presence and distribution of antigen-antibody complexes in the herniated nucleus pulposus. Spine. 1999;24:1980-4.
[CrossRef] [PubMed] [Google Scholar]

[31] Grönblad M, , Virri J, , Seitsalo S, , Habtemariam A, , Karaharju E. Inflammatory cells, motor weakness, and straight leg raising in transligamentous disc herniations. Spine. 2000;25:2803-7.
[CrossRef] [PubMed] [Google Scholar]

[32] Grönblad M, , Virri J, , Tolonen J, , Seitsalo S, , Kääpä E, , Kankare J, , et al. A controlled immunohistochemical study of inflammatory cells in disc herniation tissue. Spine. 1994;19:2744-51.
[CrossRef] [PubMed] [Google Scholar]

[33] Ito T, , Yamada M, , Ikuta F, , Fukuda T, , Hoshi SI, , Kawaji Y, , et al. Histologic evidence of absorption of sequestration-type herniated disc. Spine. 1996;21:230-4.
[CrossRef] [PubMed] [Google Scholar]

[34] Haro H, , Crawford HC, , Fingleton B, , MacDougall JR, , Shinomiya K, , Spengler DM, , et al. Matrix metalloproteinase-3-dependent generation of a macrophage chemoattractant in a model of herniated disc resorption. J Clin Invest. 2000;105:133-41.
[CrossRef] [PubMed] [Google Scholar]

[35] Haro H, , Komori H, , Kato T, , Hara Y, , Tagawa M, , Shinomiya K, , et al. Experimental studies on the effects of recombinant human matrix metalloproteinases on herniated disc tissues-how to facilitate the natural resorption process of herniated discs. J Orthop Res. 2005;23:412-9.
[CrossRef] [PubMed] [Google Scholar]

[36] Marshall LL, , Trethewie ER, , Curtain CC. Chemical radiculitis. A clinical, physiological and immunological study. Clin Orthop Relat Res. 1977;129:61-7.
[CrossRef] [Google Scholar]

[37] Modic MT, , Masaryk T, , Paushter D. Magnetic resonance imaging of the spine. Radiol Clin North Am. 1986;24:229..
[CrossRef] [PubMed] [Google Scholar]

[38] Atlas SJ, , Keller RB, , Chang Y, , Deyo RA, , Singer DE. Surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: Five-year outcomes from the Maine Lumbar Spine Study. Spine. 2001;26:1179-87.
[CrossRef] [PubMed] [Google Scholar]

[39] Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine. 1983;8:131-40.
[CrossRef] [Google Scholar]

Spontaneously disappearing large herniated lumbar disc fragment

Abstract

Keywords

Disappearing disc

herniation

lumbar disc

regression disc

spontaneous regression

Introduction

Case Report

Discussion

Conclusion

Source of Support:

Conflict of Interest:

REFERENCES

Suggested read for related articles: