Outcomes of conservative treatment for ruptured lumbar disc herniation


Published online: Dec 27 2013

Peng-fei YU, Fang-Da JIANG, Jin-Tao LIU, Hong JIANG

From Suzhou Hospital of Traditional Chinese Medicine, Suzhou, China and Duke University, Durham, NC, USA

Abstract

The authors set up a prospective study of the effect of conservative treatment on a ruptured lumbar disc herniation in 89 patients, between June 2008 and June 2010. Seventy-two patients (81%) improved, while the other 17 (19%) needed surgery. The JOA score (best possible result : 29) was found to be significantly improved in the 72 patients of the conservative group, at 1 month, 3months, 6 months, 1 year and 2 years (t-test : p < 0.001). At final follow-up, after 2 years, 84.7% of the patients in the conservative group had a good or excellent result. However, if the 17 surgical cases were included, this proportion dropped to 68.5% The volume of the protrusion decreased significantly in the 72 patients of the conservative group : from 1422.52 ± 539.10 mm3 to 1027.35 ± 585.51 mm3 (paired t-test : p < 0.001). There was a definite correlation, in the conservative group, between the final resorption rate on the one hand and the percentage of combined excellent and good results on the other hand (72 cases ; Spearman rank correlation coefficient : r 0.01 = 0.470, p < 0.001).