Objective: To explore the clinical effect of conservative treatment for giant lumbar intervertebral disc herniation and analyze the factors affecting its resorption.
Methods: From January 2013 to December 2016, the clinical data of 130 patients with giant lumbar intervertebral disc herniation were collected. The patients were classified according to the characteristics of Iwabuchi displacement and "bull eye sign", Xiaosui Huahe decoction of traditional Chinese medicine conservative treatment was used in the patients. There were 93 males and 37 females, aged from 15 to 64 years old with an average of(37.11±13.96) years old; with the disease duration ranging from 1 day to 8 years with an average of(11.82±20.45) months. Rate of intervertebral disc herniation was measured by Futian's method, and clinical effect was evaluated by JOA score.
Results: All the patients were followed up from 13 to 48 months with an average of(21.45±11.87) months, and there were no significant differences in follow-up time between different imaging types(P>0.05). The absorption rate 95 patients with persistent conservative treatment was(44.08±35.70)%. The absorption rate of Iwabuchi displacement positive group and "bull eye sign" positive group was significantly higher than the average value(P<0.05). The rate of excellent and good JOA scores in 95 patients was 78.95%, 81.05% and 78.95% at 3, 6 and 12 months after treatment, respectively(P<0.05). Finally 35 patients accepted surgical treatment, the rate of excellent and good JOA scores was 100% at 3, 6, 12 months after treatment(P<0.05).
Conclusions: The clinical effect of Xiaosui Huahe decoction conservative treatment is satisfactory for giant lumbar intervertebral disc herniation. Patients with Iwabuchi displacement and "bull's eye sign" had significant herniation resorption.
Keywords: Conservative treatment; Intervertebral disk displacement; Resorption.
Copyright© 2019 by the China Journal of Orthopaedics and Traumatology Press.