Long‐Term Course to Lumbar Disc Resorption Patients and Predictive Factors Associated with Disc Resorption

Abstract

The long-term course to lumbar intervertebral disc herniation (LDH) patients receiving integrative Korean medicine treatment and predictive factors associated with disc resorption were investigated. LDH patients who received integrative Korean medicine treatment from February 2012 to December 2015 and were registered in the “longitudinal project for LDH on MRI” were included. Disc resorption amount was measured 3-dimensionally with disc degeneration and modic change levels on baseline and follow-up MRIs. Patient characteristics, Korean medicine use, pain, symptom recurrence, and satisfaction were assessed through medical records and phone surveys. Of 505 participants, 19 did not show disc resorption, while 486 did. A total of 220 displayed resorption rates of ≥50%. LDH volume at baseline was 1399.82 ± 594.96 mm3, and that on follow-up MRI was 734.37 ± 303.33 mm3, indicating a 47.5% decrease (p < 0.0001). Predictive factors for disc resorption were disc extrusion, Komori migration classification, and LDH amount. Approximately 68.4% did not experience symptom recurrence over the 51.86 ± 19.07-month follow-up, and 90.3% were satisfied with Korean medicine treatment. The majority of LDH patients who improved after integrative Korean medicine treatment showed disc resorption within 1 year with favorable long-term outcomes. Predictive factors for disc resorption should be duly considered for informed decision-making. This trial is registered with ClinicalTrials.gov NCT02841163.

Nonsurgical integrative Korean Medicine treatment of discal cyst

“…In addition, integrative treatment consisting of electroacupuncture, Chuna therapy, cupping, physical therapy, and manual therapy used as treatment for disc diseases has been reported to induce absorption of herniated disc. [23–27] We confirmed a case in which this treatment led to the resorption of discal cysts using this treatment regimen.…”

Long-Term Follow-Up of Inpatients with Failed Back Surgery Syndrome Who Received Integrative Korean Medicine Treatment: A Retrospective Analysis and Questionnaire Survey Study

“…Regarding lumbar MRI or CT findings, patients with FBSS with HNP showed a higher OR of achieving MCID in the NRS score for LBP. This is because integrative KM treatment in patients with lumbar disc herniation has a long-term effect on disc resorption [ 31 ], as well as improvement in pain and function [ 32 , 33 ]. The principle underlying the improvement of pain caused by lumbar disc herniation is suggested by previous studies on the effects of Shinbaro [ 34 , 35 ].…”

Resorption of upwardly displaced lumbar disk herniation after nonsurgical treatment: A case report

“…The resorption of LDHs after nonsurgical treatments has been widely reported since the first case in 1984. In these reports, the LDHs were characterized as decreasing or disappearing over time, and the nonsurgical treatments in these reports included bed rest, lumbar support, analgesics, oral steroids, non-steroidal anti-inflammatory drugs, epidural steroid injection, caudal epidural injections of local anesthetic, manipulation, hot back, ultrasound, electrotherapy, traction, exercises, Traditional Chinese Medicine and integrative Korean medicine[ 3 - 16 ]. However, which of these treatments are essential for promoting resorption and the time when resorption takes place remains unclear.…”

“…The incidence of resorption varies in the existing reports depending on the different follow-up times. Lee reported the highest incidence of resorption of 96% with an average follow-up time of 341.38 ± 306.83 d[ 3 ]. Two studies reported no resorption with follow-ups of 45 d[ 4 ] and 20 d[ 5 ], suggesting that resorption should not be expected to occur too soon after nonsurgical treatments.…”

“…Resorption of LDH is one of the primary factors that contributes to relief following nonsurgical treatments; and thus has clinical significance in the nonsurgical treatment of LDH. The spontaneous resorption of LDHs has been widely reported[ 3 - 16 ]. However, the majority of these reports analyze the resorption of LDHs that were displaced backwards or downwards in the form of sequestration, extrusion, protrusion, or bulging[ 17 ].…”