Iranian Journal of Orthopedic Surgery

How Much Would Conservative Treatment Improve Lumbar Disc Herniation Symptoms and Signs?

Authors

Hamid Behtash, MD
Bahman Ghezelbash, MD
S Mohammad Fereshtehnejad, MD
Mohammad Saleh Ganjavian, MD
Ebrahim Ameri, MD
Bahram Mobini, MD
https://doi.org/10.22034/ijos.2020.121252
Abstract
Background: Low back pain is common disease which usually causes considerable individual and community-related functional disability. Lumbar disc herniation is one of the common causes of back pain in the third or forth decade of life. Surgical treatment imposes a heavy functional burden on the patient and the society. For this reason we have decided to evaluate the effectiveness of non-surgical treatment in lumber disc herniation in middle age people.Methods: Forthy five patients, who had referred with documented lumber disc herniation with positive clinical and CT scan evidence, were evaluated before and after six months of conservative treatment. The treatment included NSAID steroid 3-cyclic antidepressant, rest, physiotherapy and, at times, bracing or traction. Clinical and repeat CT scan was used for re-evaluation.Results: Among the 45 cases, clinical improvement was seen in 39 (86.7%) and 6 (13.3%) required surgical exploration. The 35 cases who referred for repeat CT scanning, 24 (68.6%) showed regression of disc bulge. Conclusions: In view of high rate of regression of symptoms and improvement on CT scans in this study, it is recommended not to rush to surgery for lumber disc herniation in non-urgent cases, and expect high rate of improvement with conservative approach.

Keywords

Intervertebral disc displacement
treatment
Low back pain

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