MRI Predictors for Improvement Without Any Intervention of Clinical Symptoms in Patients With Lumbar Disc Herniation - Questioning the True Need for Surgery

Q: What phenomenon does the study focus on in lumbar disc herniation patients?

It focuses on spontaneous resorption of a herniated lumbar disc and disappearance of clinical symptoms without any repair or intervention.

Q: How were MRI images used to evaluate predictors?

Patients underwent MRI, where spinal conditions were classified using Fardon’s, Modic’s, and Pfrman’s classifications and physical dimensions of the affected disc and herniated disc were measured.

Q: Which MRI parameters were found to predict clinical symptom resolution?

Fardon’s classification and the middle height of the affected disc were the only parameters statistically proven to be clinically relevant predictors of symptom resolution.

Sep 29, 2026

Uploaded by Adam

Prospective radiology research investigates whether patients with lumbar disc herniation can experience spontaneous resorption of the herniated disc and disappearance of clinical symptoms without any intervention. MRI-based measurements classify spinal conditions using Fardon’s, Modic’s, and Pfrman’s systems and quantify disc and herniation dimensions, with reproducibility assessed for measurement reliability. Multivariable logistic regression and ROC analysis identify predictors for symptom resolution, showing that a combined selection based on two key MRI parameters can substantially increase the likelihood of conservative-treatment success while potentially reducing the need for surgery.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Materials and Methods

Inclusion and Exclusion Criteria

Results

Conclusion

Wiley Radiology Research and Practice Volume 2026, Article ID 4954622, 8 pages [https://doi.org/10.1155/rrp/4954622](https://doi.org/10.1155/rrp/4954622) Research Article MRI Predictors for Improvement Without Any Intervention of Clinical Symptoms in Patients With Lumbar Disc Herniation, Questioning the True Need for Surgery Andrea ˇSprlkov-Pukov, 1,2 Matej Straka , 1,2 Tereza Habas , 1 Adam ˇCellr 2 , Marek Dostl , 1,3 Tamara Barusov,4 Marek Sova ,5,6 Soˇna Krytofov,5,6 and Martin Smrka 5,6 1 Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno, Czech Republic 2 Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno, Czech Republic 3 Department of Biophysics, Faculty of Medicine, Masaryk University, Brno, Czech Republic 4 Institute of Biostatistics and Analyses Ltd., Brno, Czech Republic 5 Department of Neurosurgery, University Hospital Brno, Brno, Czech Republic 6 Department of Neurosurgery, Faculty of Medicine, Masaryk University, Brno, Czech Republic Correspondence should be addressed to Marek Dost´al; [dostal.marek@fnbrno.cz](dostal.marek@fnbrno.cz) Received 18 November 2024; Revised 4 November 2025; Accepted 5 December 2025 Academic Editor: Kuo Feng Hung Copyright © 2026 Andrea ˇSprl´akov´a-Pukov´a et al. Radiology Research and Practice published by John Wiley & Sons Ltd. Tis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Introduction: Spontaneous resorption of a herniated lumbar disc and disappearance of clinical symptoms without repair is a wellknown but not well-studied phenomenon. Tis prospective study uses magnetic resonance images to search for predictors as to the possibility of spontaneous herniation resorption without any intervention and patients’ predisposition to beneft from conservative treatment. Materials and Methods: Of the 125 patients examined by magnetic resonance imaging, 22 had clinical symptoms that spontaneously (without any intervention) disappear. Te spinal condition of each was classifed using Fardon’s, Modic’s, and Pfrman’s classifcations, and physical dimensions of the afected disc and herniated disc were measured. Inter- and intrareproducibility of this measurement were determined. Predictors for spontaneous disappearance of clinical symptoms were selected using multivariable logistic regression and receiver operating characteristic (ROC) analysis. Results: Te measurement uncertainty was less than four pixels for most parameters. Fardon’s classifcation and middle height of the afected disc were the only clinically relevant parameters statistically proven to be predictors of clinical symptoms resolution (p < 0.01). By combining these appropriately, we are able to identify a group of patients who have up to 22.5 times greater chance of spontaneous regression compared to others (odds ratio 􀂈 22.5, p < 0.001) . Conclusion: By a suitable combination of the two parameters, we can select patients who are suitable candidates for conservative treatment of lumbar disc herniation and unlikely to require surgery. Keywords: conservative therapy; disc herniation; lumbar spine; MRI; spontaneous resorption 1. Introduction Degenerative spine disease is one of the most common pathological conditions in the population today. Tis condition can be accompanied by damage to the intervertebral disc and its displacement toward the spinal canal or neuroforamen, causing vertebrogenic algic syndromes, radiculopathy, and functional limitations. Magnetic resonance imaging (MRI) is the most common method for imaging the lumbar spine in cases of these 2 Radiology Research and Practice clinical symptoms, as it has high sensitivity and can best image the relationship between the disc and nerve structures without radiation burden. Te treatment of a prolapsed disc

FAQs

What phenomenon does the study focus on in lumbar disc herniation patients?

It focuses on spontaneous resorption of a herniated lumbar disc and disappearance of clinical symptoms without any repair or intervention.

How were MRI images used to evaluate predictors?

Patients underwent MRI, where spinal conditions were classified using Fardon’s, Modic’s, and Pfrman’s classifications and physical dimensions of the affected disc and herniated disc were measured.

Which MRI parameters were found to predict clinical symptom resolution?

Fardon’s classification and the middle height of the affected disc were the only parameters statistically proven to be clinically relevant predictors of symptom resolution.

Sep 29, 2026

Uploaded by Adam