The pathomorphologic changes that accompany the resolution of cervical radiculopathy. A prospective study with repeat magnetic resonance imaging.
METHODS
A prospective study with independent clinical and radiologic review.


OBJECTIVE
To assess whether regression of cervical intervertebral disc herniations accompanied and correlated with clinical improvement in patients recovering from cervical radiculopathy without undergoing surgical intervention.


BACKGROUND
The study subjects were 13 consecutive patients, nine men (69%) and four women (31%), presenting with cervical radiculopathy. All patients but one had objective neurologic signs. All patients had large posterolateral cervical intervertebral disc herniations demonstrated by magnetic resonance imaging.


METHODS
Pain was controlled by serial periradicular and epidural corticosteroid injections. Patients were finally examined and discharged from care because of sustained pain control at an average of 6 months (range, 2-12 months). They were interviewed subsequently over the telephone by an independent clinician and rescanned at an average of 12 months (range, 4-31 months). The scans were reviewed by an independent radiologist masked to the sequence of the scans.


RESULTS
Regression of cervical disc herniations was demonstrated in 12 of the 13 patients. All patients had made a satisfactory clinical recovery, but the one with the herniation that had not regressed suffered from persistent minor symptoms.


CONCLUSIONS
Most cervical disc herniations regress with time and without the need for surgical resection. Thus, surgical intervention can be avoided with adequate pain control, allowing the herniation time to regress.
Bush
K
K
London Clinic Scanning Services, United Kingdom.
Chaudhuri
R
R
Hillier
S
S
Penny
J
J
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D019412:Anatomy, Cross-Sectional; D002574:Cervical Vertebrae / Q000187:drug effects / Q000473:pathology*; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D011446:Prospective Studies; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones