• Ahmed Rizk Elkholy, Ashraf Mohamed Farid, and Ebrahim Ahmed Shamhoot.
• Neurosurgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt. Electronic address: elkholyneurosurgery@yahoo.com.
• World Neurosurg. 2019 Apr 1; 124: e453e459e453-e459.

BackgroundSpontaneous resorption of herniated lumbar disk was explained in the literature by different mechanisms, and multiple predictive factors for resorption were reported in numerous studies. The purpose of this study was to evaluate the phenomena of spontaneous resorption of herniated lumbar disk without surgery (mechanisms, predictive factors, expected time for resorption, and proper time for conservative treatment).MethodsThis retrospective clinical case series included 9 patients with herniated lumbar disk on initial magnetic resonance imaging (MRI). The mean age was 39 ± 6.3 years, and the male to female ratio was 2:1. All patients presented with back pain and sciatica without motor deficit. All patients refused surgical intervention; therefore, they were treated conservatively. Patients were followed-up clinically and radiologically (MRI) in the outpatient clinic on regular visits (for 18 months).ResultsSpontaneous resorption of herniated disk was found in all patients in a mean time of 8.7 ± 3.2 months. All patients recovered clinically in a mean time of 5.7 ± 1.6 weeks by conservative treatment. Large and/or sequestrated disks were associated with rapid resorption. Early recovery patients showed early spontaneous resorption of the disk.ConclusionsSpontaneous resorption of herniated lumbar disk can occur by different mechanisms (retraction, dehydration, and inflammatory mediated mechanism). Large and/or sequestrated disks are essential predictive factors for rapid spontaneous resorption. Furthermore, early clinical recovery is usually associated with quick resorption of the herniated disk.Copyright © 2018 Elsevier Inc. All rights reserved.

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