Characteristics and mechanisms of resorption in lumbar disc herniation

Lumbar disc herniation (LDH) can be spontaneously absorbed without surgical treatment. However, the pathogenesis and physiological indications for predicting protrusion reabsorption are still unclear, which prevents clinicians from preferentially choosing conservative treatment options for LDH patie...

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Bibliographic Details
Published in:Arthritis research & therapy 2022-08, Vol.24 (1), p.1-205, Article 205
Main Authors: Yu, Pengfei, Mao, Feng, Chen, Jingyun, Ma, Xiaoying, Dai, Yuxiang, Liu, Guanhong, Dai, Feng, Liu, Jingtao
Format: Article
Language:English
Subjects:
Analysis
Angiogenesis
Arthritis
Autoimmune response
Bone resorption
Cartilage
Cauda Equina Syndrome
Development and progression
Epidural
Hernia
Inflammation
Intervertebral disk
Intervertebral disk displacement
Lumbar disc herniation
Macrophages
Magnetic resonance imaging
Natural history
Patients
Physiological aspects
Review
Surgery
Tomography
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Summary:Lumbar disc herniation (LDH) can be spontaneously absorbed without surgical treatment. However, the pathogenesis and physiological indications for predicting protrusion reabsorption are still unclear, which prevents clinicians from preferentially choosing conservative treatment options for LDH patients with reabsorption effects. The purpose of this review was to summarize previous reports on LDH reabsorption and to discuss the clinical and imaging features that favor natural absorption. We highlighted the biological mechanisms involved in the phenomenon of LDH reabsorption, including macrophage infiltration, inflammatory responses, matrix remodeling, and neovascularization. In addition, we summarized and discussed potential clinical treatments for promoting reabsorption. Current evidence suggests that macrophage regulation of inflammatory mediators, matrix metalloproteinases, and specific cytokines in intervertebral disc is essential for the spontaneous reabsorption of LDH.
ISSN:1478-6362
1478-6354
1478-6362
DOI:10.1186/s13075-022-02894-8