The probability of spontaneous regression of lumbar herniated disc: a systematic review
The probability of spontaneous regression of lumbar herniated disc: a systematic review
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DOI：
10.1177/0269215514540919
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发表时间：
2015-02-01
影响因子：
3
通讯作者：
Hsu, Wen-Yen
中科院分区：
文献类型：
--
作者：
Chiu, Chun-Chieh;Chuang, Tai-Yuan;Hsu, Wen-Yen
目的：通过系统评价确定每种类型腰椎间盘突出症的自发性椎间盘退变概率，数据来源：Medline、科克伦图书馆、CINAHL和Web of Science，使用关键词检索2014年3月之前发表的相关原始文献。文献仅限于英文和人体研究中发表的文献。综述方法：文献必须：（1）包括接受保守治疗的腰椎间盘突出症患者;（2）至少有两次腰椎影像学评价;（3）排除既往腰椎手术、脊柱感染、肿瘤、脊椎滑脱或椎管狭窄的患者。两位评审员独立提取了研究细节和结果。31项研究符合纳入标准。此外，如果突出的分类与联合工作组推荐的分类相匹配，则将数据用于每种类型椎间盘退变概率的联合分析。9项研究适用于概率calculation.Results：自发回归率被发现是96%的椎间盘隔离，70%的椎间盘突出，41%的椎间盘突出，和13%的椎间盘膨出。椎间盘突出症的完全解决率为43%的隔离盘和15%的挤压disc.Conclusions：椎间盘突出组织的自发回归可能会发生，并可以完全解决保守治疗后。椎间盘突出和隔离的患者比椎间盘膨出或突出的患者有更高的自发性回退的可能性。椎间盘隔离的完全消退率明显高于椎间盘突出。
Objective: To determine the probability of spontaneous disc regression among each type of lumbar herniated disc, using a systematic review.Data sources: Medline, Cochrane Library, CINAHL, and Web of Science were searched using key words for relevant original articles published before March 2014. Articles were limited to those published in English and human studies.Review methods: Articles had to: (1) include patients with lumbar disc herniation treated conservatively; (2) have at least two imaging evaluations of the lumbar spine; and (3) exclude patients with prior lumbar surgery, spinal infections, tumors, spondylolisthesis, or spinal stenosis. Two reviewers independently extracted study details and findings. Thirty-one studies met the inclusion criteria. Furthermore, if the classification of herniation matched the recommended classification of the combined Task Forces, the data were used for combined analysis of the probability of disc regression of each type. Nine studies were applicable for probability calculation.Results: The rate of spontaneous regression was found to be 96% for disc sequestration, 70% for disc extrusion, 41% for disc protrusion, and 13% for disc bulging. The rate of complete resolution of disc herniation was 43% for sequestrated discs and 15% for extruded discs.Conclusions: Spontaneous regression of herniated disc tissue can occur, and can completely resolve after conservative treatment. Patients with disc extrusion and sequestration had a significantly higher possibility of having spontaneous regression than did those with bulging or protruding discs. Disc sequestration had a significantly higher rate of complete regression than did disc extrusion.