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.

Retrospective study of acupuncture treatment for canine thoracolumbar intervertebral disc herniation

Thoracolumbar interverbal disk herniation(TL-IVDH)is a common neurological disorder in dogs,which often affects the life quality of patients and their caregivers.Acupuncture is increasingly accepted by veterinarians and animal owners,and has been used in the treatment of neurologic disorders.This study aims to evaluate the effects of acupuncture treatment for canine TL-IVDH.Clinical cases from 2016 to 2021 were collected.According to the inclusion and exclusion criteria,94 TL-IVDH cases that received acupuncture treatment were selected.Clinical classification and efficacy criteria were formulated based on the Frankel Score.For each case,clinical presentation,improvement,recovery and recurrence were recorded.Male dogs with TL-IVDH accounted for 64%of all cases.The average age was 7.49 years old,the predominant breed was poodle,and the incidence site was concentrated from T11 to L1.The overall recovery rate after receiving acupuncture treatment was 79.78%,which was comparable when considering only cases with grade 2,3,or 4 spinal cord lesions(83.33%~85.19%).In conclusion,canine with grade 2,3,and 4 spinal cord lesions due to TL-IVDH receiving acupuncture had a high recovery rate,suggesting acupuncture could be a viable treatment options for canine with TL-IVDH.