We are analyzing https://link.springer.com/article/10.1186/s12891-020-03548-z.

Title:
The incidence of regression after the non-surgical treatment of symptomatic lumbar disc herniation: a systematic review and meta-analysis | BMC Musculoskeletal Disorders
Description:
Background Although the regression of symptomatic lumbar disc herniation (SLDH) has been widely reported, little data exist regarding the generalized incidence of regression (IR). We aimed to review the varying IRs and to synthesize the pooled IR of non-surgically-treated SLDH. Methods Four electronic databases were searched for relevant studies pertaining to the regression of SLDH after non-surgical treatment and for potential studies that may have reported morphological changes in lumbar disc herniation in the follow-up results of SLDH patients treated non-surgically. The main outcome was the regression of SLDH. A random effects model was used to determine the pooled IR of SLDH. Results We identified 13,672 articles, 38 of which were eligible for analysis. Our analysis included 2219 non-surgically treated SLDH patients, 1425 of whom presented regression. The pooled IR was 63% (95% CI 0.49–0.77). In subgroup analyses, studies that quantitatively measured the regression of SLDH yielded statistically higher pooled IRs than those that used qualitative methods. The pooled IRs gradually increased in randomized controlled trials and prospective and retrospective studies. The pooled IR varied from 62 to 66% after the sequential omission of any single study. Meta-regression showed that study types, herniation levels and regression measurements caused heterogeneity. Conclusions We report an overall IR of 63% among non-surgically treated SLDH patients, thus providing clinical decision makers with quantitative evidence of IR. Based on our systematic review, we suggest a follow-up timeline with time points 4 and 10.5 months after onset when deciding whether to perform surgery for SLDH.
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Keywords {🔍}

studies, regression, sldh, article, google, scholar, lumbar, disc, pubmed, patients, study, followup, herniation, included, reported, treatment, cas, clinical, nonsurgical, number, pooled, time, spine, data, treated, months, articles, imaging, review, average, metaanalysis, surgery, risk, systematic, rcts, analysis, search, irs, measurements, heterogeneity, quality, herniated, ldh, nonrandomized, bias, size, table, incidence, results, nonsurgically,

Topics {✒️}

article download pdf nonsteroidal anti-inflammatory agents effective short-term alleviation including oxygen-ozone therapy cross-sectional area measurements contrast-enhanced mr imaging delauche-cavallier [23] reported cochrane central register intervertebral disc herniation intervertebral disc herniations lumbar disc herniation lumbar disc herniations privacy choices/manage cookies evidence-based clinical guideline meta-analysis results supplement lumbar disc hernia lumbar disk herniation reported long-term follow full access lumbar herniated disc long-term effects magnetic resonance imaging multiple-level sldh patients random effects model cross-sectional views weinstein jn clinical decision makers lumbar interbody fusion herniated disc tissues van houwelingen hc placebo-controlled trial traditional chinese medicine search terms resulted creative commons licence lumbar disk prolapse important intellectual content european economic area epidural steroid injection relevant studies pertaining surgically-treated sldh patients single-level sldh patients postcontrast mr enhancement randomised controlled trial massachusetts general hospital simulated spinal manipulations mr imaging assessment search terms included early study observed clear correct decision grey squares represent

Questions {❓}

Does non-surgical spinal decompression therapy make difference?
Does postcontrast MR enhancement in lumbar disk herniation have prognostic value?
Three-dimensional analysis of volumetric changes in herniated discs of the lumbar spine: does spontaneous resorption of herniated discs always occur?

Schema {🗺️}

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         description:Although the regression of symptomatic lumbar disc herniation (SLDH) has been widely reported, little data exist regarding the generalized incidence of regression (IR). We aimed to review the varying IRs and to synthesize the pooled IR of non-surgically-treated SLDH. Four electronic databases were searched for relevant studies pertaining to the regression of SLDH after non-surgical treatment and for potential studies that may have reported morphological changes in lumbar disc herniation in the follow-up results of SLDH patients treated non-surgically. The main outcome was the regression of SLDH. A random effects model was used to determine the pooled IR of SLDH. We identified 13,672 articles, 38 of which were eligible for analysis. Our analysis included 2219 non-surgically treated SLDH patients, 1425 of whom presented regression. The pooled IR was 63% (95% CI 0.49–0.77). In subgroup analyses, studies that quantitatively measured the regression of SLDH yielded statistically higher pooled IRs than those that used qualitative methods. The pooled IRs gradually increased in randomized controlled trials and prospective and retrospective studies. The pooled IR varied from 62 to 66% after the sequential omission of any single study. Meta-regression showed that study types, herniation levels and regression measurements caused heterogeneity. We report an overall IR of 63% among non-surgically treated SLDH patients, thus providing clinical decision makers with quantitative evidence of IR. Based on our systematic review, we suggest a follow-up timeline with time points 4 and 10.5 months after onset when deciding whether to perform surgery for SLDH.
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