The natural history of sciatica: a prospective radiological study.
This prospective study was set up to record the changes in the intervertebral disc accompanying resolution of sciatica following conservative treatment. Patients presenting with sciatica (n = 165) were examined by computed tomography (CT) of the lumbar spine. Disc lesions were classified into the following groups: herniation, sequestration, generalized bulge and focal bulge. Follow-up CT of the pathological disc was performed in 106 of the 165 patients after 1 year and identical anatomical sections were compared. All patients were initially treated conservatively by the injection of steroid and local anaesthetic at the intervertebral disc/nerve root interface. Of 84 cases of disc herniation and sequestration 64 (76%) showed either complete or partial resolution on follow-up CT examination. Of 22 cases with either a generalized or focal bulge of the disc 18 (82%) were unchanged on follow up. The classical disc herniation in a young patient is the type of disc lesion most likely to show greatest improvement at follow-up CT.
Cowan
N C
NC
King's College Hospital, London.
Bush
K
K
Katz
D E
DE
Gishen
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging*; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012585:Sciatica / Q000000981:diagnostic imaging* / Q000628:therapy; D014057:Tomography, X-Ray Computed