CASE REPORT   

Chirurgia 2019 April;32(2):95-8

DOI: 10.23736/S0394-9508.18.04811-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Spontaneous regression of a large extruded disc herniation

Arash FATTAHI ¹, Morteza TAHERI ² ✉, Alireza TABIBKHOOEI ²

¹ Department of Neurosurgery, Iran University of Medical Sciences, 7Tir Hospital, Tehran, Iran; ² Iran University of Medical Sciences, Rasool Akram Hospital, Tehran, Iran

Many cases of regressed disc herniation have been reported but most of them are sequestrated or free fragment disc herniation; so regression of a large herniated disk extrusion is rare. A 34-year-old man presented S1 dermatome radicular pain and paresthesia with no neurological deficit. Lumbosacral spine magnetic resonance imaging (MRI) showed huge disk extrusion in L5/S1 level compressing left S1 root. Conservative management began. Six months later, the symptoms has been improved dramatic. The follow-up MRI showed significant decrease in disk herniation volume. Performing a lumbosacral MRI in the patients suffer from radicular pain and paresthesia, not only can demonstrates the probable cause of patients’ symptoms, also can predict the probability of regression of disk herniation. In the cases of large disk extrusion, despite disk volume, conservative treatment should be the first step because of greater potential for spontaneous regression and resolution of these situations.

KEY WORDS: Intervertebral disc displacement - Lumbar vertebrae - Conservative treatment