Journal of Korean Society of Spine Surgery (대한척추외과학회지)

Korean Society of Spine Surgery (대한척추외과학회)
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Loss of Disc Height after Spontaneous Regression of a Herniated Lumbar Disc - A Case Report -

탈출된 요추 추간판 자연 소실 후 발생한 추간판 간격 감소 - 증례 보고 -

  • 김형복 (서울부민병원 정형외과) ;
  • 정훈재 (서울부민병원 정형외과)
  • Received : 2018.09.16
  • Accepted : 2018.11.08
  • Published : 2018.12.30
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Abstract

Study Design: Case report. Objectives: We report 3 cases of loss of disc height after spontaneous regression of a herniated lumbar disc. Summary of Literature Review: Reports of spontaneous regression of a herniated lumbar disc were identified. Materials and Methods: We conservatively treated 3 patients who were diagnosed with a herniated lumbar disc. During outpatient follow-up, radiating pain improved in all patients, but they complained of chronic lower back pain. Magnetic resonance imaging (MRI) was performed for diagnostic purposes. Results: On MRI, spontaneous regression of the herniated lumbar discs was observed, but loss of disc height was also found. Conclusions: A herniated lumbar disc may be a risk factor for loss of disc height. It is important to recognize that a patient with a herniated lumbar disc can struggle with chronic lower back pain even if spontaneous regression of the herniated lumbar disc occurs.

연구 계획: 증례 보고 목적: 탈출된 요추 추간판이 자연 소실된 이후 추간판 간격이 감소된 증례를 보고하고자 한다. 선행 문헌의 요약: 보존적 치료를 통한 탈출된 요추 추간판의 자연 소실이 보고되었다. 대상 및 방법: 요추 추간판 탈출증으로 진단된 3명의 환자를 외래 추시를 통해 보존적 치료를 시행하였다. 내원 당시에 관찰되었던 방사통은 호전 되었으나, 만성적인 요통을 호소하였다. 원인 파악을 위해 MRI 촬영을 다시 시행하였다. 결과: 보존적 치료로 탈출된 요추 추간판이 자연 소실 되었지만, 추간판 간격의 현저한 감소가 관찰되었다. 결론: 요추 추간판 탈출증이 추간판 간격 감소의 위험요인 중 하나일 수 있다. 요추 추간판 탈출증을 진단 받은 환자의 경우 탈출된 요추 추간판이 자연 소실되더라도 만성 요통이 발생 할 수 있음을 인지하는 것이 중요하다.

Keywords

References

  1. Boden SD, McCowin PR, Davis DO, et al. Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990 Sep;72(8):1178-84. DOI: 10.2106/00004623-199072080-00008.
  2. Sabuncuoglu H, Ozdogan S, Timurkaynak E. Spontaneous regression of extruded lumbar disc herniation: report of two illustrative case and review of the literature. Turk Neurosurg. 2008 Oct;18(4):392-6.
  3. Guinto FC, Jr., Hashim H, Stumer M. CT demonstration of disk regression after conservative therapy. AJNR Am J Neuroradiol. 1984 Sep-Oct;5(5):632-3.
  4. Benoist M. The natural history of lumbar disc herniation and radiculopathy. Joint Bone Spine. 2002 Mar;69(2):155-60. DOI: 10.1016/S1297-319X(02)00385-8.
  5. Komori H, Shinomiya K, Nakai O, et al. The natural history of herniated nucleus pulposus with radiculopathy. Spine (Phila Pa 1976). 1996 Jan;21(2):225-9. DOI: 10.1097/00007632-199601150-00013.
  6. Teplick JG, Haskin ME. Spontaneous regression of herniated nucleus pulposus. AJR Am J Roentgenol. 1985 Aug;145(2):371-5. DOI: 10.2214/ajr.145.2.371.
  7. Slavin KV, Raja A, Thornton J, et al. Spontaneous regression of a large lumbar disc herniation : report of an illustrative case. Surg Neurol. 2001 Nov;56(5):333-6. DOI: 10.1016/S0090-3019(01)00607-3.
  8. Henmi T, Sairyo K, Nakano S, et al. Natural history of extruded lumbar intervertebral disc herniation. J Med Invest. 2002 Feb;49(1-2):40-3.
  9. Autio RA, Karppinen J, Niinimaki J, et al. Determinants of spontaneous resorption of intervertebral disc herniations. Spine (Phila Pa 1976). 2006 May;31(11):1247-52. DOI: 10.1097/01.brs.0000217681.83524.4a.
  10. Barth M, Diepers M, Weiss C, et al. Two-year outcome after lumbar microdiscectomy versus microscopic sequestrectomy: part 2: radiographic evaluation and correlation with clinical outcome. Spine (Phila Pa 1976). 2008 Feb;33(3):273-9. DOI: 10.1097/BRS.0b013e31816201a6.