Clinical Outcomes and Factors Associated with Radiological Resorption in Symptomatic Extruded or Sequestrated Lumbar Disc Herniation: A Retrospective Cohort Study.

IF 5.1 1区医学 Q1 CLINICAL NEUROLOGY

Spine Journal Pub Date : 2026-10-22 DOI:10.1016/j.spinee.2026.10.013

Zhenyu Tang, Xiaorong Li, Chengpeng Gong, Zihang Li, Kaiyang Xu, Zhijia Ma, Yan Gong, Hongda Zhou, Xiaochun Li, Zhiqiang Wang, Yucheng Wang, Hong Jiang, Yuxiang Dai, Pengfei Yu, Jintao Liu

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引用次数: 0

Abstract

Background: The relationship between resorption and long-term outcomes in extruded or sequestrated lumbar disc herniation (LDH) remains uncertain.

Purpose: To evaluate the clinical significance of resorption and factors associated with resorption timing.

Study design: Single-center retrospective cohort study.

Patient sample: 578 patients with symptomatic extruded or sequestrated LDH were managed nonsurgically and followed for ≥ 24 months.

Outcome measures: Surgery, symptomatic episodes, Oswestry Disability Index (ODI), visual analog scale (VAS), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A).

Methods: Radiological resorption was defined as ≥30% volume reduction, representing at least partial resorption. Generalized estimating equations assessed longitudinal outcomes; time-dependent Cox and landmark analyses assessed surgery; and an interval-censored model assessed resorption timing. Governmental and institutional grants provided US$100,001-500,000. No conflict-of-interest bias was identified.

Results: Resorption was documented in 256 patients (44.3%; median, 8.2 months). Surgery occurred in 0.8% versus 24.0%; resorption was associated with lower surgical risk (adjusted HR, 0.067; 95% CI, 0.015-0.292), with consistent landmark findings. The resorption group had fewer symptomatic episodes. ODI and VAS improvement was similar through 6 months but greater thereafter; HADS-A improvement was greater throughout. Komori type III (HR, 6.07; 95% CI, 3.58-10.29) and Modic type I (HR, 2.65; 95% CI, 1.25-5.60) were associated with earlier resorption. Resorption magnitude showed no consistent association with outcomes.

Conclusions: Resorption was associated with a more favorable clinical course, but improvement also occurred without resorption. Komori type III and Modic type I were associated with earlier documented resorption; resorption magnitude showed no consistent outcome association.

查看原文本刊更多论文

临床结果和与有症状的突出或隔离的腰椎间盘突出症放射吸收相关的因素：一项回顾性队列研究。

背景：突出或隔离的腰椎间盘突出症（LDH）的吸收与长期预后之间的关系尚不确定。目的：探讨骨吸收的临床意义及影响骨吸收时间的因素。研究设计：单中心回顾性队列研究。患者样本：578例有症状的LDH突出或隔离的患者采用非手术治疗，随访≥24个月。结果测量：手术、症状发作、Oswestry残疾指数（ODI）、视觉模拟量表（VAS）和医院焦虑和抑郁量表-焦虑（HADS-A）。方法：放射吸收定义为体积缩小≥30%，代表至少部分吸收。评估纵向结果的广义估计方程；时间依赖性Cox和里程碑分析评估手术；一个间隔审查模型评估了吸收时间。政府和机构赠款提供了10万至50万美元。未发现利益冲突偏见。结果：256例患者（44.3%，中位时间8.2个月）出现骨吸收。手术发生率为0.8%对24.0%；再吸收与较低的手术风险相关（校正HR， 0.067; 95% CI, 0.015-0.292），具有一致的标志性发现。吸收组症状发作较少。ODI和VAS的改善在6个月内相似，但之后更大；HADS-A的改善更大。Komori III型（HR, 6.07; 95% CI, 3.58-10.29）和Modic I型（HR, 2.65; 95% CI, 1.25-5.60）与早期吸收相关。吸收的大小与结果没有一致的关联。结论：吸收与更有利的临床病程相关，但无吸收也会出现改善。Komori III型和Modic I型与早期记录的吸收有关；吸收大小显示没有一致的结果关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine Journal 医学-临床神经学

CiteScore

8.20

自引率

6.70%

发文量

680

审稿时长

13.1 weeks

期刊介绍： The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.