Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4609-4614
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4609
Resorption of upwardly displaced lumbar disk herniation after nonsurgical treatment: A case report
Yi Wang, Shi-Chuan Liao, Guo-Gang Dai, Ling Jiang
Yi Wang, Shi-Chuan Liao, Guo-Gang Dai, Cervicodynia/Omalgia/Lumbago/Sciatica Department 2, Sichuan Provincial Orthopedics Hospital, Chengdu 610041, Sichuan Province, China
Ling Jiang, College Hospital, Sichuan Agricultural University-Chengdu Campus, Chengdu 611130, Sichuan Province, China
Author contributions: Wang Y designed the study; Liao SC collected the patient’s clinical data; Wang Y and Liao SC analyzed the data and drafted the manuscript; Dai GG and Jiang L reviewed the manuscript.
Supported by Sichuan Provincial Orthopedics Hospital, No. 202036.
Informed consent statement: The patient involved in this study gave written informed consent authorizing the use and disclosure of his protected health information.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yi Wang, MD, Doctor, Cervicodynia/Omalgia/Lumbago/Sciatica Department 2, Sichuan Provincial Orthopedics Hospital, No. 132 West First Section First Ring Road, Chengdu 610041, Sichuan Province, China. yiwang1984@hotmail.com
Received: April 26, 2020
Peer-review started: April 26, 2020
First decision: July 25, 2020
Revised: August 4, 2020
Accepted: August 20, 2020
Article in press: August 20, 2020
Published online: October 6, 2020
Abstract
BACKGROUND

The spontaneous resorption of lumbar disk herniations (LDHs) has been widely reported. However, the majority of these reports analyze the resorption of LDHs that were displaced backwards or downwards. There have been few reports on the spontaneous resorption of upwardly displaced L4/5 LDH that has caused femoral nerve symptoms.

CASE SUMMARY

A 55-year-old woman presented to our hospital with acute pain in her left leg. She had been suffering from recurrent lower back pain for approximately 1 year and began to feel pain accompanied with numbness at the anterior aspect of her left leg 7 d previously. On examination, a typical L4 nerve stimulation was noted. An upwardly displaced LDH at the L4/5 level was revealed by magnetic resonance imaging. The patient attained complete relief of her symptoms after 10 wk of nonsurgical treatment and the upwardly displaced herniation almost entirely disappeared. There was no recurrence during a follow-up of 2 years.

CONCLUSION

Clinicians should be aware that the nerves disturbed by LDHs vary according to the direction of the herniations and the probable resorption of upwardly displaced LDHs should be considered before making a decision on surgery.

Keywords: Lumbar disk herniation, Upward displacement, Resorption, Neurology, Rehabilitation, Case report

Core Tip: This is the first report of the spontaneous resorption of upwardly displaced L4/5 lumbar disk herniation that caused femoral nerve symptoms. No secular trends in the incidence of resorption were identified in the literature review.