Minim Invasive Neurosurg 2004; 47(4): 226-229
DOI: 10.1055/s-2004-818517
Original Article
© Georg Thieme Verlag Stuttgart · New York

Spontaneous Resolution of “Protruded” Lumbar Discs

S.  Keskil1 , G.  Ayberk2 , C.  Evlıyaoğlu1 , T.  Kizartici2 , E.  Yücel1 , H.  Anbarci1
  • 1Department of Neurosurgery, Kırıkkale University Medical School, Kırıkkale, Turkey
  • 2Department of Neurosurgery, Dr. M. Ü. Hospital for Emergency and Traumatology, Ankara, Turkey
Data presented in part at the 15th Congress of the Turkish Neurosurgical Association.
Weitere Informationen


03. September 2004 (online)



Decreasing size of disc material that has herniated, whether “contained” or “protruded” has previously been described and sometimes this can be so complete that residual material is barely visible. In a retrospective clinical survey, from among almost 2180 consecutive patients admitted during 1994 - 2002 with low back pain; due to our low follow-up ratios and high price of the magnetic resonance imaging (MRI), only 42 patients with a lumbar disc protrusion could be found who had two MRI scans obtained at least five weeks apart. Among these, 4 patients were spotted with a totally resolved disc protrusion. T2-weighted MRI images were suggesting shrinkage due to dehydration and regression within the annulus of protruded disc fragments that had not fully migrated. Our patients are further examples for total resolution of the large “protruded” disc without any treatment; and since concomitant disc protrusions at other levels persisted, the resolution of these discs is supposed to be spontaneous.


  • 1 Boden S D, David D O, Dina T S, Patronas N J, Wiesel S W. Abnormal magnetic resonance scans of the lumbar spine in asymptomatic subjects.  J Bone Joint Surg [Am]. 1990;  72 403-408
  • 2 Matsubara Y, Kato F, Mimatsu K, Kajino G, Nakamura S, Nitta N. Serial changes on MRI in lumbar disc herniations treated conservatively.  Neuroradiology. 1995;  37 378-383
  • 3 Teplick J G, Haskin M E. Spontaneous regression of herniated nucleus pulposus.  Am J Roentgenol. 1985;  145 371-375
  • 4 Komori H, Shinomiya K, Nakai O, Yamaura I, Takeda S, Furuya K. The natural history of herniated nucleus pulposus with radiculopathy.  Spine. 1996;  21 225-229
  • 5 Maigne J Y, Rime B, Deligne B. Computed tomographic follow-up study of forty-eight cases of non operatively treated lumbar intervertebral disc herniation.  Spine. 1992;  17 1071-1074
  • 6 Delauche-Cavallier M C, Budet C, Laredo J D, Debie B, Wybier M, Dorfmann H, Ballner I. Lumbar disc herniation: computed tomography scan changes after conservative treatment of nerve root compression.  Spine. 1992;  17 927-933
  • 7 Fager C A. Observation on spontaneous recovery from intervertebral disc herniation.  Surg Neurol. 1994;  42 282-286
  • 8 Weinreb J C, Wolbarscht L B, Cohen J M, Brown C E, Maravilla K R. Prevalence of lumbosacral intervertebral disc abnormalities on MR images in pregnant and asymptomatic non-pregnant women.  Radiology. 1989;  170 125-128
  • 9 Wiesel S W, Tsourmas N, Feffer H L, Citrin C M, Patronas N J. A study of computer assisted tomography: I. The incidence of positive CAT scans in an asymptomatic group of patients.  Spine. 1984;  9 549-551
  • 10 Deyo R A, Tsui-Wu Y J. Descriptive epidemiology of low-back pain and its related medical care in the United States.  Spine. 1987;  12 264-268
  • 11 Saal J A, Saal J S. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy: an outcome study.  Spine. 1989;  14 431-437
  • 12 Weber H. Lumbar disc herniation: A controlled, prospective study with 10 years of observation.  Spine. 1983;  8 131-139
  • 13 Bozzao A, Gallucci M, Masciocchi C, Aprile I, Barile A, Passeriello R. Lumbar disk herniation: MR imaging assessment of natural history in patients treated without surgery.  Radiology. 1992;  15 135-141

Prof. Dr. İ. Semih Keskıl

Fethiye Sokak · Ozbek Apt. No: 4/6

Gazi Osman Paşa

06700 Ankara


Telefon: +90-532-615-8422

Fax: +90-318-225-2819

eMail: sk06-k@