A meta-analysis of the incidence of resorption of lumbar disc herniation_West China Medical Journal

Authors：

WANG Yi ¹ , JIANG Ling ² ,  DAI Guogang ¹ , LI Lengtao ³ , WANG Lanjie ¹

1. Cervicodynia/Omalgia/Lumbago/Sciatica Department 2, Sichuan Provincial Orthopedic Hospital, Chengdu, Sichuan 610041, P. R. China;
2. College Hospital, Sichuan Agricultural University-Chengdu Campus, Chengdu, Sichuan 611130, P. R. China;
3. School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DAI Guogang, Email: guogang_dai@hotmail.com

Keywords：

Lumbar disc herniation; resorption; incidence; meta-analysis

DOI：

10.7507/1002-0179.202004355

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Objective To comprehensively investigate the incidence of resorption of lumbar disc herniation, and provide reference data for clinical decision-making. Methods Seven electronic databases (PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, Wangfang data and Chongqing VIP database) were searched for relevant studies that might have reported morphologic changes in lumbar disc herniation when reporting the follow-up results of patients with lumbar disc herniation treated non-surgically from inception to March, 2020. Articles were screened according to inclusion and exclusion criteria, and the total number of patients, number of patients with resorption, and other important data were extracted for analysis. Random effect models were used for meta-analysis, and subgroup analysis, sensitivity analysis, meta-regression analysis, and Egger’s test were performed. Results A total of 15712 articles were identified from these databases, and 48 were eligible for analysis. A total of 2880 non-surgically treated patients with lumbar disc herniation were included in the meta-analysis, 1740 of whom presented resorption. Meta-analysis revealed that the incidence of resorption was 0.60 [95% confidence interval (CI) (0.46, 0.72)]. In subgroup analyses, studies that quantitatively measured the resorption of lumbar disc herniation yielded statistically higher pooled incidence [0.73, 95%CI (0.60, 0.85)] than those that used qualitative methods [0.51, 95%CI (0.34, 0.69)] (P=0.0252). The pooled incidence gradually increased in randomized controlled trials (RCTs) [0.50, 95%CI (0.15, 0.85)], non-RCT prospective studies [0.59, 95%CI (0.48, 0.70)] and retrospective studies [0.69, 95%CI (0.36, 0.95)], but the difference was not statistically significant (P=0.7523). The pooled incidence varied from 0.58 [95%CI (0.54, 0.71)] to 0.62 [95%CI (0.49, 0.74)] after the sequential omission of each single study. There was no significant change in the pooled incidence [0.62, 95%CI (0.43, 0.79)] when only low-risk RCTs and high-quality non-RCT studies were included, comparing with original meta-analysis results. Meta-regression showed that measurements partially caused heterogeneity (R²=15.34%, P=0.0858). Egger’s test suggested that there was no publication bias (P=0.4622). Conclusions According to current research, there is an overall incidence of resorption of 60% [95%CI (46%, 72%)] among non-surgically treated patients with lumbar disc herniation. The probability of resorption should be fully considered before making a decision on surgery.

Citation： WANG Yi, JIANG Ling, DAI Guogang, LI Lengtao, WANG Lanjie. A meta-analysis of the incidence of resorption of lumbar disc herniation. West China Medical Journal, 2022, 37(8): 1221-1230. doi: 10.7507/1002-0179.202004355 Copy

1.	Stafford MA, Peng P, Hill DA. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth, 2007, 99(4): 461-473.
2.	Ramaswami R, Ghogawala Z, Weinstein JN. Management of sciatica. N Engl J Med, 2017, 376(12): 1175-1177.
3.	Peul WC, Van Houwelingen HC, Van Den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med, 2007, 356(22): 2245-2256.
4.	Peul WC, Van Den Hout WB, Brand R, et al. Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation: two year results of a randomised controlled trial. BMJ, 2008, 336(7657): 1355-1358.
5.	Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort. JAMA, 2006, 296(20): 2451-2459.
6.	Shriver MF, Xie JJ, Tye EY, et al. Lumbar microdiscectomy complication rates: a systematic review and meta-analysis. Neurosurg Focus, 2015, 39(4): E6.
7.	Guinto FC Jr, Hashim H, Stumer M. CT demonstration of disk regression after conservative therapy. AJNR Am J Neuroradiol, 1984, 5(5): 632-633.
8.	Teplick JG, Haskin ME. Spontaneous regression of herniated nucleus pulposus. AJR Am J Roentgenol, 1985, 145(2): 371-375.
9.	郭志英, 王颖, 苗芙蓉, 等. 腰椎间盘突出症康复治疗前后 CT 检查对比分析. 中国康复医学杂志, 1987(3): 102-104.
10.	Bozzao A, Gallucci M, Masciocchi C, et al. Lumbar disk herniation: Mr imaging assessment of natural history in patients treated without surgery. Radiology, 1992, 185(1): 135-141.
11.	Bush K, Cowan N, Katz DE, et al. The natural history of sciatica associated with disc pathology. A prospective study with clinical and independent radiologic follow-up. Spine (Phila Pa 1976), 1992, 17(10): 1205-1212.
12.	Delauche-Cavallier MC, Budet C, Laredo JD, et al. Lumbar disc herniation. Computed tomography scan changes after conservative treatment of nerve root compression. Spine (Phila Pa 1976), 1992, 17(8): 927-933.
13.	Ellenberg MR, Ross ML, Honet JC, et al. Prospective evaluation of the course of disc herniations in patients with proven radiculopathy. Arch Phys Med Rehabil, 1993, 74(1): 3-8.
14.	Ilkko E, Lähde S, Heikkinen ER. Late CT-findings in non-surgically treated lumbar disc herniations. Eur J Radiol, 1993, 16(3): 186-189.
15.	Komori H, Shinomiya K, Nakai O, et al. The natural history of herniated nucleus pulposus with radiculopathy. Spine (Phila Pa 1976), 1996, 21(2): 225-229.
16.	Yukawa Y, Kato F, Matsubara Y, et al. Serial magnetic resonance imaging follow-up study of lumbar disc herniation conservatively treated for average 30 months: relation between reduction of herniation and degeneration of disc. J Spinal Disord, 1996, 9(3): 251-256.
17.	岳寿伟, 黄丽雯, 冯德朝, 等. 腰椎间盘突出症快速牵引后 CT 随访观察. 中华理疗杂志, 1997, 20(3): 157-160.
18.	Ahn SH, Ahn MW, Byun WM. Effect of the transligamentous extension of lumbar disc herniations on their regression and the clinical outcome of sciatica. Spine (Phila Pa 1976), 2000, 25(4): 475-480.
19.	韩永珍, 姚馥兰, 陈菊春, 等. 腰椎间盘突出症的物理治疗及 CT 随访复查. 颈腰痛杂志, 2000, 21(3): 237-238.
20.	王晓玉, 郭淑红, 侯毅鞠, 等. 推拿六法治疗腰椎间盘突出症. 现代康复, 2000, 4(7): 1006-1007.
21.	余润明, 陶文, 孙安达, 等. 牵引推拿复位术治疗中央型腰椎间盘突出症的临床研究. 山东中医药大学学报, 2000, 24(6): 425-427.
22.	Takada E, Takahashi M, Shimada K. Natural history of lumbar disc hernia with radicular leg pain: spontaneous MRI changes of the herniated mass and correlation with clinical outcome. J Orthop Surg (Hong Kong), 2001, 9(1): 1-7.
23.	Buttermann GR. Lumbar disc herniation regression after successful epidural steroid injection. J Spinal Disord Tech, 2002, 15(6): 469-476.
24.	Henmi T, Sairyo K, Nakano S, et al. Natural history of extruded lumbar intervertebral disc herniation. J Med Invest, 2002, 49(1/2): 40-43.
25.	Autio RA, Karppinen J, Niinimäki J, et al. Determinants of spontaneous resorption of intervertebral disc herniations. Spine (Phila Pa 1976), 2006, 31(11): 1247-1252.
26.	Jensen TS, Albert HB, Soerensen JS, et al. Natural course of disc morphology in patients with sciatica: an MRI study using a standardized qualitative classification system. Spine (Phila Pa 1976), 2006, 31(14): 1605-1612.
27.	Ozturk B, Gunduz OH, Ozoran K, et al. Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation. Rheumatol Int, 2006, 26(7): 622-626.
28.	Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J, 2006, 6(2): 131-137.
29.	王永东, 毕素清, 王国强, 等. 腰椎间盘突出能否还纳复位的临床分析. 颈腰痛杂志, 2006, 27(4): 275-276.
30.	Cribb GL, Jaffray DC, Cassar-Pullicino VN. Observations on the natural history of massive lumbar disc herniation. J Bone Joint Surg Br, 2007, 89(6): 782-784.
31.	Broetz D, Hahn U, Maschke E, et al. Lumbar disk prolapse: response to mechanical physiotherapy in the absence of changes in magnetic resonance imaging. Report of 11 cases. NeuroRehabilitation, 2008, 23(3): 289-294.
32.	徐涛, 杨忠华, 王霖. 针药并用治疗腰椎间盘突出症 56 例临床观察. 新中医, 2009, 41(12): 86-88.
33.	Iwabuchi M, Murakami K, Ara F, et al. The predictive factors for the resorption of a lumbar disc herniation on plain MRI. Fukushima J Med Sci, 2010, 56(2): 91-97.
34.	Kamanli A, Karaca-Acet G, Kaya A, et al. Conventional physical therapy with lumbar traction; clinical evaluation and magnetic resonance imaging for lumbar disc herniation. Bratisl Lek Listy, 2010, 111(10): 541-544.
35.	刘建兴, 张晓阳, 徐俊. 腰椎间盘突出自然演变的 MRI 观察. 广东医学, 2010, 31(5): 576-577.
36.	刘锦涛, 姜宏, 徐坤林, 等. 非手术疗法对腰椎间盘突出后重吸收的影响(附 30 例分析). 中国骨与关节损伤杂志, 2010, 25(11): 978-980.
37.	郑寿鹏, 尼哈提. 鹿瓜多肽与甲钴胺联合治疗腰椎间盘突出症的临床观察. 中国医药, 2010, 5(2): 160-161.
38.	葛恒清. 针刀治疗对促进腰椎间盘突出后自然吸收现象的临床观察. 世界中医药, 2011, 6(6): 506-507.
39.	孟彩云. 腰椎间盘突出后自然吸收(针刀疗法)的疗效观察及护理分析. 中国中医药现代远程教育, 2011, 9(16): 42-43.
40.	El Barzouhi A, Vleggeert-Lankamp CLAM, Lycklama À Nijeholt GJ, et al. Magnetic resonance imaging in follow-up assessment of sciatica. N Engl J Med, 2013, 368(11): 999-1007.
41.	冯伟, 冯天有, 毕永民, 等. 借助 3D-MRI 扫描探讨脊柱(定点)旋转复位法治疗腰椎间盘突出症的临床研究. 中国骨伤, 2013, 26(6): 476-480.
42.	Shan Z, Fan S, Xie Q, et al. Spontaneous resorption of lumbar disc herniation is less likely when modic changes are present. Spine (Phila Pa 1976), 2014, 39(9): 736-744.
43.	Shin JS, Lee J, Kim MR, et al. The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study. BMJ Open, 2014, 4(9): e005801.
44.	戴国钢, 刘剑伟, 楚福明, 等. 破碎型腰椎间盘突出的诊治分析. 四川医学, 2014, 35(10): 1281-1284.
45.	俞鹏飞, 姜宏, 刘锦涛. 破裂型腰椎间盘突出症非手术治疗后的转归. 中国脊柱脊髓杂志, 2015, 25(2): 109-114.
46.	Hong SJ, Kim DY, Kim H, et al. Resorption of massive lumbar disc herniation on MRI treated with epidural steroid injection: a retrospective study of 28 cases. Pain Physician, 2016, 19(6): 381-388.
47.	郑杨, 汪丽佩, 黄杰烽, 等. 口服补阳还五汤联合功能锻炼治疗后纵韧带破裂型腰椎间盘突出症. 中医正骨, 2016, 28(7): 49-52.
48.	Demirel A, Yorubulut M, Ergun N. Regression of lumbar disc herniation by physiotherapy. Does non-surgical spinal decompression therapy make a difference? Double-blind randomized controlled trial. J Back Musculoskelet Rehabil, 2017, 30(5): 1015-1022.
49.	Lee J, Shin JS, Lee YJ, et al. Long-term course and predictive factors associated with disc resorption in lumbar disc herniation patients. J Neuroll Sci, 2017, 381: 278.
50.	戴锋, 俞鹏飞, 徐坤林, 等. 中医药保守治疗破裂型腰椎间盘突出症 42 例. 中国中医骨伤科杂志, 2017, 25(11): 56-58.
51.	王玉巧. 持续牵引配合推拿手法治疗腰椎间盘突出症临床观察. 内蒙古中医药, 2017, 36(14): 118.
52.	Kesikburun B, Eksioglu E, Turan A, et al. Spontaneous regression of extruded lumbar disc herniation: correlation with clinical outcome. Pak J Med Sci, 2019, 35(4): 974-980.
53.	孙博文, 蔡亚楼, 许建峰, 等. 烙灸联合腰背肌功能锻炼对后纵韧带破裂型腰椎间盘突出症患者髓核重吸收及复发率的影响. 甘肃中医药大学学报, 2019, 36(1): 60-63.
54.	颜宾宏, 牛乾, 符致坚, 等. 丹鹿通督片治疗腰椎间盘突出症肾虚瘀阻证的疗效与机制. 中国实验方剂学杂志, 2019, 25(22): 66-71.
55.	王丰, 戴国钢, 夏娇, 等. 腰椎矢状面平衡重塑对腰椎间盘破裂突出后自然吸收的影响. 海南医学院学报, 2020, 26(13): 1028-1032.
56.	Kreiner DS, Hwang SW, Easa JE, et al. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J, 2014, 14(1): 180-191.
57.	Higgins JP, Altman DG, Gotzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
58.	Slim K, Nini E, Forestier D, et al. Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg, 2003, 73(9): 712-716.
59.	罗美玲, 谭红专, 周权, 等. 在 R 软件中实现单个率的 Meta 分析. 循证医学, 2013, 13(3): 181-184, 188.
60.	Higgins JPT TJ, Chandler J, Cumpston M, et al. Cochrane handbook for systematic reviews of interventions version 6.0 (updated July 2019). Cochrane, 2019. www.training.cochrane.org/handbook.
61.	Zhong M, Liu JT, Jiang H, et al. Incidence of spontaneous resorption of lumbar disc herniation: a meta-analysis. Pain Physician, 2017, 20(1): E45-E52.
62.	Chiu CC, Chuang TY, Chang KH, et al. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil, 2015, 29(2): 184-195.

1. Stafford MA, Peng P, Hill DA. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth, 2007, 99(4): 461-473.
2. Ramaswami R, Ghogawala Z, Weinstein JN. Management of sciatica. N Engl J Med, 2017, 376(12): 1175-1177.
3. Peul WC, Van Houwelingen HC, Van Den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med, 2007, 356(22): 2245-2256.
4. Peul WC, Van Den Hout WB, Brand R, et al. Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation: two year results of a randomised controlled trial. BMJ, 2008, 336(7657): 1355-1358.
5. Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort. JAMA, 2006, 296(20): 2451-2459.
6. Shriver MF, Xie JJ, Tye EY, et al. Lumbar microdiscectomy complication rates: a systematic review and meta-analysis. Neurosurg Focus, 2015, 39(4): E6.
7. Guinto FC Jr, Hashim H, Stumer M. CT demonstration of disk regression after conservative therapy. AJNR Am J Neuroradiol, 1984, 5(5): 632-633.
8. Teplick JG, Haskin ME. Spontaneous regression of herniated nucleus pulposus. AJR Am J Roentgenol, 1985, 145(2): 371-375.
9. 郭志英, 王颖, 苗芙蓉, 等. 腰椎间盘突出症康复治疗前后 CT 检查对比分析. 中国康复医学杂志, 1987(3): 102-104.
10. Bozzao A, Gallucci M, Masciocchi C, et al. Lumbar disk herniation: Mr imaging assessment of natural history in patients treated without surgery. Radiology, 1992, 185(1): 135-141.
11. Bush K, Cowan N, Katz DE, et al. The natural history of sciatica associated with disc pathology. A prospective study with clinical and independent radiologic follow-up. Spine (Phila Pa 1976), 1992, 17(10): 1205-1212.
12. Delauche-Cavallier MC, Budet C, Laredo JD, et al. Lumbar disc herniation. Computed tomography scan changes after conservative treatment of nerve root compression. Spine (Phila Pa 1976), 1992, 17(8): 927-933.
13. Ellenberg MR, Ross ML, Honet JC, et al. Prospective evaluation of the course of disc herniations in patients with proven radiculopathy. Arch Phys Med Rehabil, 1993, 74(1): 3-8.
14. Ilkko E, Lähde S, Heikkinen ER. Late CT-findings in non-surgically treated lumbar disc herniations. Eur J Radiol, 1993, 16(3): 186-189.
15. Komori H, Shinomiya K, Nakai O, et al. The natural history of herniated nucleus pulposus with radiculopathy. Spine (Phila Pa 1976), 1996, 21(2): 225-229.
16. Yukawa Y, Kato F, Matsubara Y, et al. Serial magnetic resonance imaging follow-up study of lumbar disc herniation conservatively treated for average 30 months: relation between reduction of herniation and degeneration of disc. J Spinal Disord, 1996, 9(3): 251-256.
17. 岳寿伟, 黄丽雯, 冯德朝, 等. 腰椎间盘突出症快速牵引后 CT 随访观察. 中华理疗杂志, 1997, 20(3): 157-160.
18. Ahn SH, Ahn MW, Byun WM. Effect of the transligamentous extension of lumbar disc herniations on their regression and the clinical outcome of sciatica. Spine (Phila Pa 1976), 2000, 25(4): 475-480.
19. 韩永珍, 姚馥兰, 陈菊春, 等. 腰椎间盘突出症的物理治疗及 CT 随访复查. 颈腰痛杂志, 2000, 21(3): 237-238.
20. 王晓玉, 郭淑红, 侯毅鞠, 等. 推拿六法治疗腰椎间盘突出症. 现代康复, 2000, 4(7): 1006-1007.
21. 余润明, 陶文, 孙安达, 等. 牵引推拿复位术治疗中央型腰椎间盘突出症的临床研究. 山东中医药大学学报, 2000, 24(6): 425-427.
22. Takada E, Takahashi M, Shimada K. Natural history of lumbar disc hernia with radicular leg pain: spontaneous MRI changes of the herniated mass and correlation with clinical outcome. J Orthop Surg (Hong Kong), 2001, 9(1): 1-7.
23. Buttermann GR. Lumbar disc herniation regression after successful epidural steroid injection. J Spinal Disord Tech, 2002, 15(6): 469-476.
24. Henmi T, Sairyo K, Nakano S, et al. Natural history of extruded lumbar intervertebral disc herniation. J Med Invest, 2002, 49(1/2): 40-43.
25. Autio RA, Karppinen J, Niinimäki J, et al. Determinants of spontaneous resorption of intervertebral disc herniations. Spine (Phila Pa 1976), 2006, 31(11): 1247-1252.
26. Jensen TS, Albert HB, Soerensen JS, et al. Natural course of disc morphology in patients with sciatica: an MRI study using a standardized qualitative classification system. Spine (Phila Pa 1976), 2006, 31(14): 1605-1612.
27. Ozturk B, Gunduz OH, Ozoran K, et al. Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation. Rheumatol Int, 2006, 26(7): 622-626.
28. Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J, 2006, 6(2): 131-137.
29. 王永东, 毕素清, 王国强, 等. 腰椎间盘突出能否还纳复位的临床分析. 颈腰痛杂志, 2006, 27(4): 275-276.
30. Cribb GL, Jaffray DC, Cassar-Pullicino VN. Observations on the natural history of massive lumbar disc herniation. J Bone Joint Surg Br, 2007, 89(6): 782-784.
31. Broetz D, Hahn U, Maschke E, et al. Lumbar disk prolapse: response to mechanical physiotherapy in the absence of changes in magnetic resonance imaging. Report of 11 cases. NeuroRehabilitation, 2008, 23(3): 289-294.
32. 徐涛, 杨忠华, 王霖. 针药并用治疗腰椎间盘突出症 56 例临床观察. 新中医, 2009, 41(12): 86-88.
33. Iwabuchi M, Murakami K, Ara F, et al. The predictive factors for the resorption of a lumbar disc herniation on plain MRI. Fukushima J Med Sci, 2010, 56(2): 91-97.
34. Kamanli A, Karaca-Acet G, Kaya A, et al. Conventional physical therapy with lumbar traction; clinical evaluation and magnetic resonance imaging for lumbar disc herniation. Bratisl Lek Listy, 2010, 111(10): 541-544.
35. 刘建兴, 张晓阳, 徐俊. 腰椎间盘突出自然演变的 MRI 观察. 广东医学, 2010, 31(5): 576-577.
36. 刘锦涛, 姜宏, 徐坤林, 等. 非手术疗法对腰椎间盘突出后重吸收的影响(附 30 例分析). 中国骨与关节损伤杂志, 2010, 25(11): 978-980.
37. 郑寿鹏, 尼哈提. 鹿瓜多肽与甲钴胺联合治疗腰椎间盘突出症的临床观察. 中国医药, 2010, 5(2): 160-161.
38. 葛恒清. 针刀治疗对促进腰椎间盘突出后自然吸收现象的临床观察. 世界中医药, 2011, 6(6): 506-507.
39. 孟彩云. 腰椎间盘突出后自然吸收(针刀疗法)的疗效观察及护理分析. 中国中医药现代远程教育, 2011, 9(16): 42-43.
40. El Barzouhi A, Vleggeert-Lankamp CLAM, Lycklama À Nijeholt GJ, et al. Magnetic resonance imaging in follow-up assessment of sciatica. N Engl J Med, 2013, 368(11): 999-1007.
41. 冯伟, 冯天有, 毕永民, 等. 借助 3D-MRI 扫描探讨脊柱(定点)旋转复位法治疗腰椎间盘突出症的临床研究. 中国骨伤, 2013, 26(6): 476-480.
42. Shan Z, Fan S, Xie Q, et al. Spontaneous resorption of lumbar disc herniation is less likely when modic changes are present. Spine (Phila Pa 1976), 2014, 39(9): 736-744.
43. Shin JS, Lee J, Kim MR, et al. The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study. BMJ Open, 2014, 4(9): e005801.
44. 戴国钢, 刘剑伟, 楚福明, 等. 破碎型腰椎间盘突出的诊治分析. 四川医学, 2014, 35(10): 1281-1284.
45. 俞鹏飞, 姜宏, 刘锦涛. 破裂型腰椎间盘突出症非手术治疗后的转归. 中国脊柱脊髓杂志, 2015, 25(2): 109-114.
46. Hong SJ, Kim DY, Kim H, et al. Resorption of massive lumbar disc herniation on MRI treated with epidural steroid injection: a retrospective study of 28 cases. Pain Physician, 2016, 19(6): 381-388.
47. 郑杨, 汪丽佩, 黄杰烽, 等. 口服补阳还五汤联合功能锻炼治疗后纵韧带破裂型腰椎间盘突出症. 中医正骨, 2016, 28(7): 49-52.
48. Demirel A, Yorubulut M, Ergun N. Regression of lumbar disc herniation by physiotherapy. Does non-surgical spinal decompression therapy make a difference? Double-blind randomized controlled trial. J Back Musculoskelet Rehabil, 2017, 30(5): 1015-1022.
49. Lee J, Shin JS, Lee YJ, et al. Long-term course and predictive factors associated with disc resorption in lumbar disc herniation patients. J Neuroll Sci, 2017, 381: 278.
50. 戴锋, 俞鹏飞, 徐坤林, 等. 中医药保守治疗破裂型腰椎间盘突出症 42 例. 中国中医骨伤科杂志, 2017, 25(11): 56-58.
51. 王玉巧. 持续牵引配合推拿手法治疗腰椎间盘突出症临床观察. 内蒙古中医药, 2017, 36(14): 118.
52. Kesikburun B, Eksioglu E, Turan A, et al. Spontaneous regression of extruded lumbar disc herniation: correlation with clinical outcome. Pak J Med Sci, 2019, 35(4): 974-980.
53. 孙博文, 蔡亚楼, 许建峰, 等. 烙灸联合腰背肌功能锻炼对后纵韧带破裂型腰椎间盘突出症患者髓核重吸收及复发率的影响. 甘肃中医药大学学报, 2019, 36(1): 60-63.
54. 颜宾宏, 牛乾, 符致坚, 等. 丹鹿通督片治疗腰椎间盘突出症肾虚瘀阻证的疗效与机制. 中国实验方剂学杂志, 2019, 25(22): 66-71.
55. 王丰, 戴国钢, 夏娇, 等. 腰椎矢状面平衡重塑对腰椎间盘破裂突出后自然吸收的影响. 海南医学院学报, 2020, 26(13): 1028-1032.
56. Kreiner DS, Hwang SW, Easa JE, et al. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J, 2014, 14(1): 180-191.
57. Higgins JP, Altman DG, Gotzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
58. Slim K, Nini E, Forestier D, et al. Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg, 2003, 73(9): 712-716.
59. 罗美玲, 谭红专, 周权, 等. 在 R 软件中实现单个率的 Meta 分析. 循证医学, 2013, 13(3): 181-184, 188.
60. Higgins JPT TJ, Chandler J, Cumpston M, et al. Cochrane handbook for systematic reviews of interventions version 6.0 (updated July 2019). Cochrane, 2019. www.training.cochrane.org/handbook.
61. Zhong M, Liu JT, Jiang H, et al. Incidence of spontaneous resorption of lumbar disc herniation: a meta-analysis. Pain Physician, 2017, 20(1): E45-E52.
62. Chiu CC, Chuang TY, Chang KH, et al. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil, 2015, 29(2): 184-195.

West China Medical Journal

A meta-analysis of the incidence of resorption of lumbar disc herniation

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