Maigne J Y, Rime B, Royer P, Maigne R
Service de Rééducation, Hôpital de l'Hôtel-Dieu, Paris.
Rev Rhum Mal Osteoartic. 1991 May;58(5):355-9.
The subject of this prospective study was to appreciate the natural history of 34 herniated lumbar nucleus pulposus after recovery excluding surgical or intra-discal therapy. First CT scan was performed when radicular pain was worst, second CT between 1 and 32 months after recovery (6 to 40 months after the first CT). After the first 18 months, 18 herniations decreased more than 50% (group I) and 7 less than 25% (group II). Most herniations of group II were large or middle sized and two narrowing of discs were observed between the two CT. Group II was made of small sized herniations and 4 discs out of 7 narrowed. Beyond 18 months, herniations decreased more than 75% excepted one being calcified. Decrease of herniations and of intra-discal pressure were observed in the study. Both could allow recovery.
这项前瞻性研究的主题是了解34例腰椎间盘突出症患者在排除手术或椎间盘内治疗后恢复过程中的自然病程。首次CT扫描在神经根性疼痛最严重时进行，第二次CT扫描在恢复后1至32个月（首次CT扫描后6至40个月）进行。在最初的18个月后，18例突出物缩小超过50%（第一组），7例缩小不到25%（第二组）。第二组中的大多数突出物为大或中等大小，且在两次CT扫描之间观察到两个椎间盘狭窄。第二组由小尺寸突出物组成，7个椎间盘中有4个变窄。超过18个月后，除1例钙化外，突出物缩小超过75%。研究中观察到突出物和椎间盘内压力均下降。两者都有助于恢复。
