Metamorphosis of a herniated lumbar disc

Compression of nerve roots by herniated intervertebral discs (IVD) is a major cause of lumbosacral radiculopathy and often causes problems in patient management. We present a case report of a patient whose initial pain was axial discogenic in nature, probably due to a fissure of the annulus fibrosus...

Full description

Saved in:
Bibliographic Details
Main Authors: A. I. Isaykin, L. T. Akhmedzhanova, S. R. Fedoseev, V. D. Zagranichnaya
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2023-10-01
Series:Неврология, нейропсихиатрия, психосоматика
Subjects:
Online Access:https://nnp.ima-press.net/nnp/article/view/2104
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850186676204208128
author A. I. Isaykin
L. T. Akhmedzhanova
S. R. Fedoseev
V. D. Zagranichnaya
author_facet A. I. Isaykin
L. T. Akhmedzhanova
S. R. Fedoseev
V. D. Zagranichnaya
author_sort A. I. Isaykin
collection DOAJ
description Compression of nerve roots by herniated intervertebral discs (IVD) is a major cause of lumbosacral radiculopathy and often causes problems in patient management. We present a case report of a patient whose initial pain was axial discogenic in nature, probably due to a fissure of the annulus fibrosus, and who later developed LIII–IV radiculopathy. The timing of formation of a sequestered IVD hernia was recorded on MRI. There was no prolonged gradual formation of IVD hernia (bulging, fissure, protrusion, extrusion/sequestration), an acute formation of disc herniation occurred. Conservative treatment, including nonpharmacological (McKenzie gymnastics, educational program) and drug treatment (nonsteroidal anti-inflammatory drugs, anticonvulsants), as well as minimally invasive measures (epidural administration of local anesthetics and glucorticoids), allowed rapid regression of clinical symptoms and improvement of functional and emotional status. MRI of the lumbar spine performed six months after onset showed complete resorption of the IVD hernia. The patient follows ergonomic recommendations and performs therapeutic exercises (Nordic walking); no deterioration was observed within 9 months.
format Article
id doaj-art-677f3187cd7a4a15ba9eaf405c233eee
institution OA Journals
issn 2074-2711
2310-1342
language Russian
publishDate 2023-10-01
publisher IMA-PRESS LLC
record_format Article
series Неврология, нейропсихиатрия, психосоматика
spelling doaj-art-677f3187cd7a4a15ba9eaf405c233eee2025-08-20T02:16:18ZrusIMA-PRESS LLCНеврология, нейропсихиатрия, психосоматика2074-27112310-13422023-10-01155465310.14412/2074-2711-2023-5-46-531425Metamorphosis of a herniated lumbar discA. I. Isaykin0L. T. Akhmedzhanova1S. R. Fedoseev2V. D. Zagranichnaya3N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Compression of nerve roots by herniated intervertebral discs (IVD) is a major cause of lumbosacral radiculopathy and often causes problems in patient management. We present a case report of a patient whose initial pain was axial discogenic in nature, probably due to a fissure of the annulus fibrosus, and who later developed LIII–IV radiculopathy. The timing of formation of a sequestered IVD hernia was recorded on MRI. There was no prolonged gradual formation of IVD hernia (bulging, fissure, protrusion, extrusion/sequestration), an acute formation of disc herniation occurred. Conservative treatment, including nonpharmacological (McKenzie gymnastics, educational program) and drug treatment (nonsteroidal anti-inflammatory drugs, anticonvulsants), as well as minimally invasive measures (epidural administration of local anesthetics and glucorticoids), allowed rapid regression of clinical symptoms and improvement of functional and emotional status. MRI of the lumbar spine performed six months after onset showed complete resorption of the IVD hernia. The patient follows ergonomic recommendations and performs therapeutic exercises (Nordic walking); no deterioration was observed within 9 months.https://nnp.ima-press.net/nnp/article/view/2104disc herniationdiscogenic radiculopathydiscogenic painincidence of disc herniationregression of disc herniationpathogenesis of disc herniationnonsteroidal anti-inflammatory drugsaceclofenacconservative treatment of disc herniation
spellingShingle A. I. Isaykin
L. T. Akhmedzhanova
S. R. Fedoseev
V. D. Zagranichnaya
Metamorphosis of a herniated lumbar disc
Неврология, нейропсихиатрия, психосоматика
disc herniation
discogenic radiculopathy
discogenic pain
incidence of disc herniation
regression of disc herniation
pathogenesis of disc herniation
nonsteroidal anti-inflammatory drugs
aceclofenac
conservative treatment of disc herniation
title Metamorphosis of a herniated lumbar disc
title_full Metamorphosis of a herniated lumbar disc
title_fullStr Metamorphosis of a herniated lumbar disc
title_full_unstemmed Metamorphosis of a herniated lumbar disc
title_short Metamorphosis of a herniated lumbar disc
title_sort metamorphosis of a herniated lumbar disc
topic disc herniation
discogenic radiculopathy
discogenic pain
incidence of disc herniation
regression of disc herniation
pathogenesis of disc herniation
nonsteroidal anti-inflammatory drugs
aceclofenac
conservative treatment of disc herniation
url https://nnp.ima-press.net/nnp/article/view/2104
work_keys_str_mv AT aiisaykin metamorphosisofaherniatedlumbardisc
AT ltakhmedzhanova metamorphosisofaherniatedlumbardisc
AT srfedoseev metamorphosisofaherniatedlumbardisc
AT vdzagranichnaya metamorphosisofaherniatedlumbardisc