4.2 Review

Characteristics and mechanisms of resorption in lumbar disc herniation

Journal

ARTHRITIS RESEARCH & THERAPY
Volume 24, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s13075-022-02894-8

Keywords

Lumbar disc herniation; Autoimmune response; Inflammation; Macrophages; Angiogenesis

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Funding

  1. National Natural Science Foundation of China [82004393, 82074467]
  2. National Natural Science Foundation of Jiangsu, China [BK20190191, BK20201180]

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This review summarizes previous reports on the spontaneous absorption of lumbar disc herniation (LDH) and discusses the clinical and imaging features that favor natural absorption. Macrophage infiltration, inflammatory responses, matrix remodeling, and neovascularization are highlighted as the biological mechanisms involved in LDH reabsorption. Furthermore, potential clinical treatments for promoting reabsorption are summarized and discussed.
Lumbar disc herniation (LDH) can be spontaneously absorbed without surgical treatment. However, the pathogenesis and physiological indications for predicting protrusion reabsorption are still unclear, which prevents clinicians from preferentially choosing conservative treatment options for LDH patients with reabsorption effects. The purpose of this review was to summarize previous reports on LDH reabsorption and to discuss the clinical and imaging features that favor natural absorption. We highlighted the biological mechanisms involved in the phenomenon of LDH reabsorption, including macrophage infiltration, inflammatory responses, matrix remodeling, and neovascularization. In addition, we summarized and discussed potential clinical treatments for promoting reabsorption. Current evidence suggests that macrophage regulation of inflammatory mediators, matrix metalloproteinases, and specific cytokines in intervertebral disc is essential for the spontaneous reabsorption of LDH.

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