Which is the Most Effective Radiological Parameter for Predicting Early Regression in Acute Lumbar Disc Herniation?

Abstract

Objective: The aim of this study is to investigate the effectiveness of radiological parameters that can predict early regression in symptomatic lumbar disc herniation by quantitatively measuring the regression. Method: This cross-sectional study included 39 patients (23 males and 16 females) admitted to neurosurgery outpatient clinics with lumbar and leg pain between 2018-2019 who had been diagnosed with lumbar disc herniation via MRI, and underwent conservative treatment due to the absence of sphinctre urinary-fecal incontinence and foot drop in their neurological examination. The type, density, relationship with posterior longitunidal ligament (PLL), size and degree of migration of disc herniation that could be predictive for regression were recorded. Results: Sequestration&extrusion cases had significantly higher regression than protrusion cases (p=0.018). Hyperintense cases had significantly higher regression than the others (iso-hipointens) (p=0.042). Cases with migration had significantly higher regression than the non-migration (p=0.017). Among all parameters, migration was the most strongly associated parameter with early regression of lumbar disc herniations. Conclusions: Our study showed that sequestered-extruded, hyperintense, and highly migrated disc herniations in the early period of symptomatic lumbar disc herniation are more associated with regression and migration is the strongest radiological parameter.