Department of Joints and Soft Tissue Injury, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.
Guangzhou University of Chinese Medicine, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou, China.
J Int Med Res. 2021 Nov;49(11):3000605211058987. doi: 10.1177/03000605211058987.
Lumbar disc herniation is a common disorder in adults that is accompanied by lower back and radicular pain. A 32-year-old man visited our clinic with 1-week history of persistent lower back pain and weakness in his right big toe. Magnetic resonance imaging (MRI) of his lumbar spine revealed herniated discs at L3/L4, L5/S1 and L4/L5, where a right-sided intraspinal mass lesion deep to the L4 vertebral body was causing compression of the nerve root. The patient underwent conservative treatment and reported no symptoms referrable to his back or leg 4 months later. Follow-up MRI showed no herniation of the nucleus pulposus at the L4/L5 level or lesion deep to the vertebral body of L4, whereas no changes had occurred to the status of the herniated L3/L4 and L5/S1 discs. The present case and a literature review show that a sequestered lumbar disc herniation can regress within a relatively short timeframe without surgery. The authors emphasise the utility of conservative therapy for patients who do not have a definitive surgical indication.
腰椎间盘突出症是一种常见于成年人的疾病，伴有下腰痛和神经根痛。一名 32 岁男性因持续下腰痛和右脚大脚趾无力就诊于我院。腰椎 MRI 显示 L3/L4、L5/S1 和 L4/L5 椎间盘突出，L4 椎体右侧椎管内肿块压迫神经根。患者接受了保守治疗，4 个月后报告背部和腿部无任何症状。随访 MRI 显示 L4/L5 水平的椎间盘核无突出，L4 椎体深部无病变，而 L3/L4 和 L5/S1 椎间盘突出的状况无变化。本病例及文献复习表明，游离型腰椎间盘突出症可在较短时间内自行消退，无需手术。作者强调了对于没有明确手术指征的患者，保守治疗的实用性。
