Abstract
The long-term course to lumbar intervertebral disc herniation (LDH) patients receiving integrative Korean medicine treatment and predictive factors associated with disc resorption were investigated. LDH patients who received integrative Korean medicine treatment from February 2012 to December 2015 and were registered in the “longitudinal project for LDH on MRI” were included. Disc resorption amount was measured 3-dimensionally with disc degeneration and modic change levels on baseline and follow-up MRIs. Patient characteristics, Korean medicine use, pain, symptom recurrence, and satisfaction were assessed through medical records and phone surveys. Of 505 participants, 19 did not show disc resorption, while 486 did. A total of 220 displayed resorption rates of ≥50%. LDH volume at baseline was 1399.82 ± 594.96 mm3, and that on follow-up MRI was 734.37 ± 303.33 mm3, indicating a 47.5% decrease (p < 0.0001). Predictive factors for disc resorption were disc extrusion, Komori migration classification, and LDH amount. Approximately 68.4% did not experience symptom recurrence over the 51.86 ± 19.07-month follow-up, and 90.3% were satisfied with Korean medicine treatment. The majority of LDH patients who improved after integrative Korean medicine treatment showed disc resorption within 1 year with favorable long-term outcomes. Predictive factors for disc resorption should be duly considered for informed decision-making. This trial is registered with ClinicalTrials.gov NCT02841163.
Highlights
Recent developments in the modernization of traditional Oriental medicine include greater integration with medical technology and devices toward greater efficacy, safety, and diagnostic and prognostic accuracy
Prevalence estimates for sciatica have been reported to range from 1.6% in the general population to 43% in select working populations, and the most commonly cited cause of sciatica is lumbar intervertebral disc herniation (IDH) [1]
A total of 660 patients were registered in the “longitudinal project for IDH on magnetic resonance imaging (MRI)” and underwent baseline and followup MRIs
Summary
Recent developments in the modernization of traditional Oriental medicine include greater integration with medical technology and devices toward greater efficacy, safety, and diagnostic and prognostic accuracy. An estimated 10% of lumbar IDH patients consider surgery due Evidence-Based Complementary and Alternative Medicine to continuous pain and/or neurological deficit, and accurate prediction of development into chronic pain is of importance [6]. Advances in radiological examination have revealed how IDH may be spontaneously resorbed in time with resolution of neurological symptoms [9], and various factors predictive of disc resorption are being studied as they hold valuable information on chronicization and need for surgical intervention [10,11,12,13,14,15,16]
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