Herniated disc resorption without surgical treatment A case report.

Abstract

Introduction: Lumbar disc herniation is a disease that affects more than 5% of the population; the prevalence of herniated discs is in the range of 1-3% of chronic pain, and only 15% of all cases of LDH have surgical intervention. The main therapeutic plan options include surgical treatment; in some cases, they are maintained with conservative treatment.

Clinical case: A 33-year-old woman with a history of back pain and low back pain for three years; 6 months earlier, after performing a Valsalva maneuver, he presented intense pain 10/10 in the lower back radiating to the inner part of the right thigh and the groin. Difficulty walking and performing daily activities was significant. The pain changed very little with the intake of NSAIDs. On physical examination, the patient had grade 1 obesity and normal blood pressure. There was evidence of a slight decrease in the strength of the right foot during dorsiflexion.

Diagnostic workshop: After imaging studies, a hernia was observed at the L4-L5 level in magnetic resonance imaging of the lumbar spine, located centrally and insinuating toward the body of S1.

Evolution: Bilateral L3-L4, L4-L5, and L5-S1 facet blocks were performed. In subsequent controls, he reported a notable decrease in progressive pain. After three months, he lost weight to a high standard body mass index, and with rehabilitation, he received education in spinal ergometry in daily activities (spine school). Pain decreased by 90%, referring only to weakness. The disc lesions disappeared between 6 and 12 months in MRI control.

Conclusions: In the present case of a herniated disc, modifiable factors such as obesity and poor ergonomics, once corrected, contributed to the disappearance of spinal lesions and improvement of symptoms.