Long-Term Course to Lumbar Disc Resorption Patients and Predictive Factors Associated with Disc Resorption

Jinho Lee, Joowon Kim, Joon-Shik Shin, Yoon Jae Lee, Me-Riong Kim, Seon-Yeong Jeong, Young-Jun Choi, Tae Kyung Yoon, Byung-Heon Moon, Su-Bin Yoo, Jungsoo Hong, In-Hyuk Ha, Jinho Lee, Joowon Kim, Joon-Shik Shin, Yoon Jae Lee, Me-Riong Kim, Seon-Yeong Jeong, Young-Jun Choi, Tae Kyung Yoon, Byung-Heon Moon, Su-Bin Yoo, Jungsoo Hong, In-Hyuk Ha

Abstract

The long-term course to lumbar intervertebral disc herniation (LDH) patients receiving integrative Korean medicine treatment and predictive factors associated with disc resorption were investigated. LDH patients who received integrative Korean medicine treatment from February 2012 to December 2015 and were registered in the "longitudinal project for LDH on MRI" were included. Disc resorption amount was measured 3-dimensionally with disc degeneration and modic change levels on baseline and follow-up MRIs. Patient characteristics, Korean medicine use, pain, symptom recurrence, and satisfaction were assessed through medical records and phone surveys. Of 505 participants, 19 did not show disc resorption, while 486 did. A total of 220 displayed resorption rates of ≥50%. LDH volume at baseline was 1399.82 ± 594.96 mm3, and that on follow-up MRI was 734.37 ± 303.33 mm3, indicating a 47.5% decrease (p < 0.0001). Predictive factors for disc resorption were disc extrusion, Komori migration classification, and LDH amount. Approximately 68.4% did not experience symptom recurrence over the 51.86 ± 19.07-month follow-up, and 90.3% were satisfied with Korean medicine treatment. The majority of LDH patients who improved after integrative Korean medicine treatment showed disc resorption within 1 year with favorable long-term outcomes. Predictive factors for disc resorption should be duly considered for informed decision-making. This trial is registered with ClinicalTrials.gov NCT02841163.

Figures

Figure 1
Figure 1
Flow diagram of the study.
Figure 2
Figure 2
Associations between herniated disc volume on baseline MRI, volume on follow-up MRI, change in volume, disc herniation resorption rate, and age. (a) Association between herniated disc volume on baseline MRI and resorption rate. y = 0.19 + 0.0001703x, R2 = 0.2148, p ≤ 0.001. (b) Association between herniated disc volume on follow-up MRI and age. y = 944.39 − 5.37x, R2 = 0.0326, p ≤ 0.001. (c) Association between change in herniated disc volume and age. y = 744.62 − 2.03x, R2 = 0.0016, p = 0.362.

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