Spontaneous regression of sequestrated lumbar disc herniations: Literature review

Mohamed Macki, Marta Hernandez-Hermann, Mohamad Bydon, Aaron Gokaslan, Kelly McGovern, Ali Bydon

Research output: Contribution to journalReview article

25 Scopus citations

Abstract

Lumbar disc herniations (LDH) may regress with conservative management; however, this phenomenon is poorly understood for the sequestrated subtype of LDH. We present one of the first comprehensive literature reviews specifically addressing the spontaneous regression of sequestrated intervertebral discs. We reviewed all publications with lumbar disc herniations, sequestrated subtype. Our results were then narrowed to patients who experienced spontaneous regression of the sequestration. Based on our literature review of 53 cases, patients with sequestrated lumbar disc herniations experienced symptomatic resolution in a mean of 1.33 ± 1.34 months and radiographic resolution in 9.27 ± 13.32 months. Symptomatic patients with sequestrated discs present similarly to those with other types of lumbar disc herniations. Sequestrations may have the highest likelihood to radiographically regress in the shortest time frame in comparison to the remaining subtypes of LDH. The most likely mechanism for regression is an inflammatory response elicited against the free fragment. Patients with disc sequestrations may be managed conservatively, in the absence of intractable pain, inability to walk, weakness or symptoms suggestive of cauda equina syndrome.

Original languageEnglish (US)
Pages (from-to)136-141
Number of pages6
JournalClinical Neurology and Neurosurgery
Volume120
DOIs
StatePublished - May 2014

Keywords

  • Disc
  • Herniation
  • Lumbar
  • Regression
  • Sequestrated

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Macki, M., Hernandez-Hermann, M., Bydon, M., Gokaslan, A., McGovern, K., & Bydon, A. (2014). Spontaneous regression of sequestrated lumbar disc herniations: Literature review. Clinical Neurology and Neurosurgery, 120, 136-141. https://doi.org/10.1016/j.clineuro.2014.02.013