Fan Zhirong, Xu Nengneng, Qi Ji, Su Haitao, Wang Haizhou
The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
Panyu Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 511401, China.
Heliyon. 2023 Sep 9;9(9):e20041. doi: 10.1016/j.heliyon.2023.e20041. eCollection 2023 Sep.
A common spinal condition known as lumbar disc herniation (LDH) can result in radicular and low back discomfort. A 27-year-old man was admitted to our hospital with a 6-year history of persistent low back pain, and his low back pain had recurred with radiation to his lower extremities over the last two months. An extensive right-sided paracentral disc herniation in the L5/S1 intervertebral region, which compressed the nerve root, was discovered by magnetic resonance imaging (MRI) of his lumbar spine. After receiving conservative treatment, the patient reported that his lower back discomfort and neurogenic claudication had gradually subsided after 4 months. After one year, a follow-up MRI showed that the massive, prolapsed disc herniation at the L5/S1 level had totally disappeared. The sagittal protrusion length of the L5/S1 intervertebral disc shrank from 12.35 mm to 3.49 mm. However, there remained a chance of vertebral height loss. During the course of treatment, the height of the L5/S1 intervertebral space was still slightly reduced. The intervertebral space height declined from 7.705 mm to 7.201 mm after one year of treatment. The current case and a review of the literature demonstrate that LDH can decrease with conservative therapy over a short period of time. We stress the effectiveness of conservative treatment in very select LDH cases that lack a clear surgical justification.
一种常见的脊柱疾病——腰椎间盘突出症（LDH），可导致神经根性疼痛和下背部不适。一名27岁男性因持续下背部疼痛6年入院，在过去两个月里，他的下背部疼痛复发并向下肢放射。通过腰椎磁共振成像（MRI）发现，其L5/S1椎间区域右侧广泛的旁中央型椎间盘突出，压迫了神经根。接受保守治疗后，患者报告称4个月后下背部不适和神经源性间歇性跛行逐渐缓解。一年后，随访MRI显示L5/S1水平巨大的、脱垂的椎间盘突出已完全消失。L5/S1椎间盘矢状位突出长度从12.35毫米缩小至3.49毫米。然而，仍存在椎体高度丢失的可能性。在治疗过程中，L5/S1椎间隙高度仍略有降低。治疗一年后，椎间隙高度从7.705毫米降至7.201毫米。当前病例及文献回顾表明，腰椎间盘突出症在短期内通过保守治疗可减轻。我们强调，在缺乏明确手术指征的特定腰椎间盘突出症病例中，保守治疗是有效的。
