Herniated Lumbar Discs Sometimes Regress on Their Own: Spontaneous regression of lumbar disk herniation in patients who did not undergo surgery nor interventional therapy is reported in up to 70% of cases. At MRI 6-month follow-up, spontaneous regression of disk herniation was observed in 35% of cases. Among these, free fragments regressed in 100% of cases, herniations with high signal intensity on T2w sequences in 85%, herniations with peripheral contrast-enhancement in 83% of cases. Disk-herniation evolution did not show any relationship with location, size and level. Spontaneous resolution of lumbar disk herniation: predictive signs for prognostic evaluation. Splendiani A, Puglielli E, et al. University of L'Aquila, Italy. Neuroradiology. 2004 Nov;46(11):916-22

Herniated Lumbar Discs: 75% Handled Without Surgery: In a retrospective review of 1092 medical records to determine the epidemiological, clinical, imaging study, and therapeutic characteristics of mechanical sciatica, the average patient age was 45, and 62% of patients were women. A history of low back pain was noted in 35% of cases. A single nerve root was involved in 68% of cases, and L5 was the most commonly affected root. Disk herniation was the cause in 58%. First-line conservative treatment provided relief in 75%, and the overall 6-month outcome was favorable in 76%. Factors associated with adverse 6-month outcomes were heavy labor (odds ratio (OR) = 1.69; P = 0.049) and obesity (OR = 1.5; P = 0.05). Factors predicting outcomes of mechanical sciatica: a review of 1092 cases. Bejia I, Younes M, et al. Monastir Hospital, Tunisia.

Herniated Discs: MRI High False Positive and Negative: The magnetic resonance imaging studies and discography followed by computed tomography in 55 patients with cervical discogenic pain were evaluated. There were 161 disc levels that successfully underwent cervical discography with 79 positive levels. A positive discography result was found in 63% of dark (hypointense signal) discs and 45% of speckled discs. Fifty-nine percent of small herniated discs and 59% of torn discs had a positive discography, respectively. There were 100 abnormal cervical discs on magnetic resonance imaging. Magnetic resonance imaging had a false-positive rate of 51% and a false-negative rate of 27%. Successful cervical fusion was achieved in 95% of patients, and the overall satisfactory result was 76%. Value of magnetic resonance imaging and discography in determining the level of cervical discectomy and fusion. Zheng Y, Liew SM, Simmons ED. The State University of New York at Buffalo. Spine. 2004 Oct 1;29(19):2140-5

Herniated Discs: Vertebral axial decompression: (VAX-D) is capable of reducing intradiscal pressure to the negative range. In low back pain patients who were referred to a neurosurgical practice after failing standard medical therapy, one group of patients received an average course of treatment consisting of 18 daily sessions and another group received half that number of daily treatment sessions. The higher dosage group had a 76% remission rate vs. 43% with the lower.  (p< 0.0001). Efficacy of vertebral axial decompression on chronic low back pain: study of dosage regimen. Ramos G. McAllen, TX. Neurol Res. 2004 Apr;26(3):320-4.

Herniated Discs: Outcome of Cervical Disc Surgery: In a retrospective review of 111 consecutive patients who underwent percutaneous cervical discectomy with a mean follow-up of 49.4 months, the outcome, based on the Macnab criteria, were excellent in 47%, good in 33%, fair in 8%, and poor in 12%, thereby indicating a symptomatic improvement in 88% of the patients. In this study, the two major factors predicting an excellent long-term outcome were the symptom of radiating arm pain (P = 0.02) and the location of lateral disc herniation (P < 0.02). Factors predicting excellent outcome of percutaneous cervical discectomy: analysis of 111 consecutive cases. Ahn Y, Lee SH, et al., Wooridul Spine Hospital, Seoul, Korea. Neuroradiology. 2004 May;46(5):378-84.

Herniated Discs: Outcome of Cervical Disc Surgery: In a 3-year follow-up random assignment study of 169 patients with a large herniation of the lumbar nucleus pulposus (a herniation of >25% of the cross-sectional area of the spinal canal), 100 patients who had no improvement after a minimum of six weeks of noninvasive treatment received either epidural steroid injection or discectomy. Patients who had undergone discectomy had the most rapid decrease in symptoms, with 92% to 98% of the patients reporting that the treatment had been successful. Only 42% to 56% of the patients who had undergone the epidural steroid injection reported that the treatment had been effective. Those who did not obtain relief from the injection had a subsequent discectomy, and their outcomes did not appear to have been adversely affected by the delay in surgery resulting from the trial of epidural steroid injection. Treatment of lumbar disc herniation: epidural steroid injection compared with discectomy. A prospective, randomized study. Buttermann GR. Stillwater, MN. J Bone Joint Surg Am. 2004 Apr;86-A(4):670-9; Percutaneous disc decompression is also used and helps some. Orthop Clin North Am. 2004 Jan;35(1):17-23. Discectomy and fusion with an implantable titanium (or carbon) cage is also being done. Spine J. 2004 Mar-Apr;4(2):184-91; Intradiscal electrothermal therapy, heating the joint space to 90 degrees centigrade, was more helpful than a placebo therapy, although benefit was modest, e.g., 54% with 50% pain relief after 2-years. Tyler, TX. Spine J. 2004 Jan-Feb;4(1):27-35 and Spine J. 2002 Sep-Oct;2(5):343-50

Herniated Discs: Back Pain Higher in Osteoporosis, DJD, or Lumbar Disc Prolapse: In 1-month prevalence of back pain in 2,108 Danish twins over age 69 showed no significant difference between mono- and dizygotic twins. A current or previous diagnosis of osteoporosis, degenerative joint disease, or lumbar disc prolapse was found to significantly affect the risk of back pain. Additive genetic effects explained approximately one fourth of the liability to report back pain in men and none of the occurrence in women. Individual environmental effects were found to explain roughly 75% of the occurrence of back pain in men and 100% in women. Genetic and environmental contributions to back pain in old age: a study of 2,108 danish twins aged 70 and older. Hartvigsen J, Christensen K, et al. University of Southern Denmark, Odense. Spine. 2004 Apr 14;29(8):897-901

Herniated Discs: Steroids Didn't Help Outcome in Back Pain: Intradiscal steroid injections do not improve the clinical outcome in patients with discogenic back pain compared with placebo in a 120 patient 1-year follow-up DB PC study. Spine. 2004 Apr 14;29(8):833-6

Lumbar Spine Disc Space Narrowing Linked to Knee and Hip Osteoarthritis: In a 9-year follow-up study of 796 paired lumbar spine radiographs for anterior osteophytes (AO) and disc space narrowing (DSN) at each lumbar disc space (L1-5), progression rates for AO and DSN were 4% per annum and 3% per annum, respectively. Progression of DSN was predicted by age, back pain, and radiographic hip and knee osteoarthritis (OA). Progression of AO was predicted by age and radiographic hip OA, with borderline significance for BMI >30. No significant effects were seen for smoking, physical activity, hormone replacement therapy use, multiparity, or hand OA. Risk factors for progression of lumbar spine disc degeneration: the Chingford Study. Hassett G, Hart DJ, et al. St. Thomas' Hospital, London, UK. Arthritis Rheum. 2003 Nov;48(11):3112-7.

Lumbar DJD Helped by Glucosamine-Chondroitin Injection: In a 1-year follow-up study of 30 adults with chronic intractable low back pain of 8.5 years duration and lumbar discography with reproduction of pain, lumbar intervertebral discs were injected with a solution of glucosamine and chondroitin sulfate combined with hypertonic dextrose and dimethlysulfoxide (DMSO) to induce proteoglycan synthesis. Posttreatment scores were 6.4 vs. 12.0 at baseline (p<.001): 17 of the 30 patients (57%) improved markedly with an average of 72% improvement in disability scores and 76% in visual analogue scores. The other 13 patients (43%) had little or no improvement. Patients who did poorly included those with failed spinal surgery, spinal stenosis and long-term disability. There were no complications or serious side effects, although postinjection pain was moderate to severe for 48 to 72 hours and required epidural steroids in five cases. Biochemical injection treatment for discogenic low back pain: a pilot study. Klein RG, Eek BC, et al. Santa Barbara, CA. Spine J. 2003 May-Jun;3(3):220-6.

Lumbar DJD Possible Helped by Glucosamine-Chondroitin: In an individual case, oral intake of glucosamine and chondroitin sulfate for two years was associated with disk recovery (brightening of MRI signal) in a case of symptomatic spinal disc degeneration. The substances are bioavailable to cartilage chondrocytes, may stimulate the biosynthesis and inhibit the breakdown of their extracellular matrix proteoglycans. Long-term glucosamine and chondroitin sulfate intake may counteract symptomatic spinal disc degeneration, particularly at an early stage. Glucosamine and chondroitin sulfate supplementation to treat symptomatic disc degeneration: biochemical rationale and case report. van Blitterswijk WJ, van de Nes JC, Wuisman PI. Antoni van Leeuwenhoek Hospital,  Amsterdam, The Netherlands. BMC Complement Altern Med. 2003 Jun 10;3(1):2. Ed: Obviously, one case doesn't prove anything. However, DB PC studies have shown these substances halt OA joint space deterioration in osteoarthritic knees, which is a risk factor for lumbar spine disc deterioration.