title: Spontaneous resorption of a large cervical herniated nucleus pulposus.
abstract: The majority of patients with symptomatic herniated discs can be successfully and conservatively managed and can achieve clinical improvement without surgical intervention. Resorption of the herniated nucleus pulposus (HNP) is 1 conservative mechanism for clinical improvement. We present the case of a 76-year-old healthy man with acute cervical radicular right arm pain and positive Spurling test. Magnetic resonance imaging (MRI) showed a large disc extrusion behind the C6 vertebral body, causing severe central canal stenosis and right-greater-than-left foraminal stenosis. The patient did not want surgical intervention, and his symptoms resolved with conservative treatment. A follow-up MRI 7 months after his initial presentation showed almost complete resorption of the herniated disc. The patient returned to his normal activities and has not had recurrence of symptoms for 2 years. This report provides an interesting example of complete resorption of a large, extruded cervical herniated disc in a symptomatic patient and a review of the literature on resorption of herniated discs. The review suggests that larger herniations with an epidural location (penetration of the posterior longitudinal ligament) have a greater chance of resorption.
authors.affiliation: Rush University Medical Center, Chicago, IL. gregory_cvetanovich@rush.edu.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Cvetanovich
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Hsu
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Frank
authors.forename: Howard S
authors.initials: HS
authors.lastname: An
authors.forename: Gunnar B
authors.initials: GB
authors.lastname: Andersson
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis*; D008297:Male; D012075:Remission, Spontaneous; D013130:Spinal Stenosis / Q000175:diagnosis* / Q000209:etiology