Abstract

Spontaneous Disappearance of Large Herniated Disk Fragments

Highlights

  • Examples of spontaneous resolution of neurosurgical conditions are rare – with the exception of intracranial hemorrhages that resorb over time and distal bacterial aneurysms that may heal without surgery, most anatomical and functional problems that come to attention of neurosurgeons remain stable or worsen during follow up

  • There are, instances when, for whatever reason, the patients refuse to have surgery and continue their non‐surgical management. This improvement may translate complete resolution of initial symptoms, most often radicular pain that was produced by mechanical compression of the nerve root by the herniated disk or its sequestered fragment

  • The article by Orief et al [5] on spontaneous disappearance of herniated disks documents such phenomenon in 6 patients, one of whom had this occur at the cervical level and the other five – at lower lumbar

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Summary

Introduction

Examples of spontaneous resolution of neurosurgical conditions are rare – with the exception of intracranial hemorrhages that resorb over time and distal bacterial aneurysms that may heal without surgery, most anatomical and functional problems that come to attention of neurosurgeons remain stable or worsen during follow up. The indications for surgical discectomy are very straightforward, and whenever such patient presents with motor deficits, autonomic symptoms, severe pain that persisted for more than 3 months and has not improved (or improved only temporarily) with percutaneous interventions and systemic medications, and convincing radiographic evidence of disk herniation concordant with the patient’s symptoms in terms of level and side of radiculopathy or myelopathy, the surgery in suggested / recommended.

Results
Conclusion
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