Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu Province, China.
Clin Spine Surg. 2024 Jul 1;37(6):256-269. doi: 10.1097/BSD.0000000000001490. Epub 2023 Jul 31.
A meta-analysis.
This study aimed to analyze the incidence of spontaneous resorption of lumbar disk herniation (LDH) after conservative treatment.
The resorption of intervertebral disks has been more frequently reported, but there is a lack of reference to the probability of resorption.
We strictly refer to the standard established in the PRISMA (Preferred Reporting Items for a Systematic Review and Meta-analysis) statement, comprehensively searched electronic databases using the terms related to the spontaneous resorption of LDH. Two reviewers independently evaluated the potential studies, extracted, and analyzed the enrolled data.
Thirty-one studies with 2233 patients who received conservative treatment were included for this analysis. We found that the pooled overall incidence of disk resorption was 70.39%, 87.77% for disk sequestration, 66.91% for disk extrusion, 37.53% for disk protrusion, and 13.33% for disk bugle, respectively. The resorption incidence in of 25%≤ reduction of disk herniation (RDH) 50%, RDH≥50%, and RDH=100% were 40.19%, 43.62, and 36.89%. The resorption incidence was 66.98% in Japan, 61.66% in the United States, 83.52% in Korea, 60.68% in China, 78.30% in the UK, 56.70% in Italy, and 83.68% in Turkey, respectively. Subgroup analysis showed that there was no significant difference in resorption incidence among prospective, retrospective studies and randomized controlled trials ( P =0.77), and there was no significant difference in evaluation method among qualitative and quantitative studies ( P =0.05).
The existing evidence shows that the overall resorption incidence of LDH was 70.39%, the resorption incidence of ruptured LDH is higher than that of contained LDH. There are significant differences in the resorption incidence among countries. The resorption process mainly occurred within 6 months of conservative treatment.
荟萃分析。
本研究旨在分析保守治疗后腰椎间盘突出症（LDH）自然吸收的发生率。
椎间盘吸收的报道越来越多，但缺乏对吸收概率的参考。
我们严格参照 PRISMA（系统评价和荟萃分析的首选报告项目）声明中建立的标准，使用与 LDH 自然吸收相关的术语全面搜索电子数据库。两名审查员独立评估潜在的研究，提取并分析纳入的数据。
纳入了 31 项研究，共 2233 名接受保守治疗的患者。我们发现，椎间盘总体吸收的合并发生率为 70.39%，椎间盘游离的发生率为 87.77%，椎间盘突出的发生率为 66.91%，椎间盘膨出的发生率为 37.53%，椎间盘喇叭状突出的发生率为 13.33%。25%≤椎间盘突出减少 50%（RDH）、RDH≥50%和 RDH=100%的吸收发生率分别为 40.19%、43.62%和 36.89%。日本的吸收发生率为 66.98%，美国为 61.66%，韩国为 83.52%，中国为 60.68%，英国为 78.30%，意大利为 56.70%，土耳其为 83.68%。亚组分析显示，前瞻性、回顾性研究和随机对照试验之间的吸收发生率无显著差异（P=0.77），定性和定量研究之间的评估方法无显著差异（P=0.05）。
现有证据表明，LDH 的总体吸收发生率为 70.39%，破裂型 LDH 的吸收发生率高于包容型 LDH。各国之间的吸收发生率存在显著差异。吸收过程主要发生在保守治疗的 6 个月内。
