Effects of lumbar sagittal balance remodeling on natural absorption after lumbar disc herniation

Objective:To explore the influence of the changes of sagittal balance index of lumbar spine on the natural absorption after lumbar disc rupture and protrusion.Methods:From August 2016 to August 2017,64 patients with ruptured lumbar disc herniation and treated with natural absorption in our hospital were selected as the research subjects.According to the size of the herniated discs after 2 years,the subjects were divided into the reabsorption lumbar disc herniation group(group 1,2,3,and 4)and the non-reabsorption group(group 0).The pelvic incidence angle(PI),the sacral slope(SS),the pelvic tilting(PT),and the lumbar lordosis(LL)were measured and compared at the time of admission and 2 years after follow-up.Results:There were no significant differences in the PI value and the change of PI value during the entry and re-examination of different groups.There was no significant difference in the PT,SS,and LL values among the patients in each group;At the time of reexamination,the PT had a decreasing trend and the SS and LL had an increasing trend.With the increase of the patient's score,the changes in PT,SS,and LL values showed an increasing trend.Conclusion:The PT,SS and LL values of patients with lumbar intervertebral disc herniation had significant changes before and after treatment.Changes in the sagittal balance index of the lumbar spine were important factors affecting the natural absorption of lumbar disc herniation.

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

BACKGROUND The spontaneous resorption of lumbar disk herniations(LDHs)has been widely reported.However,the majority of these reports analyze the resorption of LDHs that were displaced backwards or downwards.There have been few reports on the spontaneous resorption of upwardly displaced L4/5 LDH that has caused femoral nerve symptoms.CASE SUMMARY A 55-year-old woman presented to our hospital with acute pain in her left leg.She had been suffering from recurrent lower back pain for approximately 1 year and began to feel pain accompanied with numbness at the anterior aspect of her left leg 7 d previously.On examination,a typical L4 nerve stimulation was noted.An upwardly displaced LDH at the L4/5 level was revealed by magnetic resonance imaging.The patient attained complete relief of her symptoms after 10 wk of nonsurgical treatment and the upwardly displaced herniation almost entirely disappeared.There was no recurrence during a follow-up of 2 years.CONCLUSION Clinicians should be aware that the nerves disturbed by LDHs vary according to the direction of the herniations and the probable resorption of upwardly displaced LDHs should be considered before making a decision on surgery.