Natural history and nonoperative treatment of lumbar disc herniation.

Abstract:

:Lumbar disc herniation is a common condition with a favorable prognosis in the majority of circumstances. This article reviews the published scientific evidence regarding the impact of nonoperative care on this condition. The published studies are critiqued and evaluated on their relative strengths and weaknesses. The effect of time, medications, exercise, injection therapy, and manipulation are considered. The literature regarding the natural history process of disc resorption is reviewed, including time frames and the proposed underlying mechanisms that may enhance or impede this process. The effect of inflammation on treatment effectiveness and decision-making is evaluated. The possible impact of various types and locations of lumbar disc herniation, coexisting anatomic factors, lumbar disc herniation material type, lumbar disc herniation material chemical factors, clinical characteristics, and patient-related factors are discussed. Appropriate candidates for operative versus nonoperative care are discussed. Conclusions are drawn from this literature review that will help guide management decisions.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Saal JA

doi

10.1097/00007632-199612151-00002

subject

Has Abstract

pub_date

1996-12-15 00:00:00

pages

2S-9S

issue

24 Suppl

eissn

0362-2436

issn

1528-1159

journal_volume

21

pub_type

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