Case Report
Spontaneous Regression of Herniated Lumbar Disc with New
Disc Protrusion in the Adjacent Level
Tayfun Hakan
1,2
and Serkan Gürcan
3
1
Te Vocational School of Health Services, Okan University, 34959 Tuzla, Turkey
2
Neurosurgery Clinic, International Kolan Hospital, S ¸is ¸li, Istanbul, Turkey
3
˙
Istanbul Gelis ¸im University, Avcılar, 34315
˙
Istanbul, Turkey
Correspondence should be addressed to Tayfun Hakan; tayfunhakan@yahoo.com
Received 20 April 2016; Revised 2 June 2016; Accepted 5 June 2016
Academic Editor: Ali F. Ozer
Copyright © 2016 T. Hakan and S. G¨ urcan. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Spontaneous regression of herniated lumbar discs was reported occasionally. Te mechanisms proposed for regression of disc
herniation are still incomplete. Tis paper describes and discusses a case of spontaneous regression of herniated lumbar discs
with a new disc protrusion in the adjacent level. A 41-year-old man was admitted with radiating pain and numbness in the lef
lower extremity with a lef posterolateral disc extrusion at L5-S1 level. He was admitted to hospital with low back pain due to disc
herniation caudally immigrating at L4-5 level three years ago. He refused the surgical intervention that was ofered and was treated
conservatively at that time. He had no neurological defcit and a history of spontaneous regression of the extruded lumbar disc;
so, a conservative therapy, including bed rest, physical therapy, nonsteroidal anti-infammatory drugs, and analgesics, was advised.
In conclusion, herniated lumbar disc fragments may regress spontaneously. Reports are prone to advise conservative treatment
for extruded or sequestrated lumbar disc herniations. However, these patients should be followed up closely; new herniation at
adjacent/diferent level may occur. Furthermore, it is important to know which herniated disk should be removed and which should
be treated conservatively, because disc herniation may cause serious complications as muscle weakness and cauda equine syndrome.
1. Introduction
Lumbar disc herniation continues to be a common health
problem by decreasing the life quality and limiting the
functions of the musculoskeletal system. Medical or surgical
treatment can be chosen according to the clinical signs
and symptoms of the patients. In some cases, spontaneous
regression of herniated lumbar disc, protruded, extruded, or
sequestrated, can be seen. It is a well-known phenomenon
since Guinto et al. [1] demonstrated it as the frst time in 1983.
Examples of this rare condition, disappearance of herniated
discs, were reported occasionally [2–4]. Te symptoms of the
patients may improve and they may return to their active
life with the spontaneous absorption of the disc material.
Spontaneous regression of lumbar disc herniation and a new
disc protrusion in adjacent level is an exceptional condition
that was reported only once in the literature [5]. Recurrence
or reherniation of intervertebral disc is a common compli-
cation; but a new herniation in diferent segment without
any recurrence is unusual. It is clear that the underlying
mechanisms of disc herniation and resorption processes are
very complex; as the factors cause a new disc herniation in
adjacent level, the regeneration and/or reparation systems
of the previously disturbed spine segment resist strongly
reherniation.
Here, an additional case of a patient who experienced a
new extruded lumbar disc herniation following the resorp-
tion of the previous herniation at the adjacent level is
presented.
2. Case Presentation
A 41-year-old man was admitted with ten-day history of
radiating pain and numbness in the lef lower extremity.
Hindawi Publishing Corporation
Case Reports in Orthopedics
Volume 2016, Article ID 1538072, 4 pages
http://dx.doi.org/10.1155/2016/1538072