• Objective: To examine the surgical results of unilateral lumbar discectomy in patients with bilateral leg pain and discuss short- and long-term outcomes within the limits of lumbar decompression. (researchgate.net)
  • Methods: We analyzed 60 patients with unilateral disk herniation who underwent unilateral lumbar discectomy and hemipartial laminectomy between 2014 and 2017. (researchgate.net)
  • Since the introduction of lumbar microdiscectomy in the 1970's, many studies have attempted to compare the effectiveness of this method with that of standard open discectomy with conflicting results. (uit.no)
  • This observational study is designed to compare the relative effectiveness of microdiscectomy (MD) with open discectomy (OD) for treating lumbar disc herniation, -within a large cohort, recruited from daily clinical practice. (uit.no)
  • Microscopic lumbar discectomy surgery involves the use of a microscope to improve surgical lighting and vision, making the herniated lumbar disc surgery more precise and accurate. (texasspineandneurosurgerycenter.com)
  • These sutures usually dissolve on their own in the body and do not need to be removed after microscopic lumbar discectomy surgery. (texasspineandneurosurgerycenter.com)
  • Patients undergoing minimally invasive microlumbar discectomy surgery to treat herniated lumbar discs may often be able to go home the same day they have surgery, as the procedure is often done on an outpatient basis. (texasspineandneurosurgerycenter.com)
  • METHODS The DaneSpine database was used to identify 2399 patients with LDH and baseline BP visual analog scale (VAS) scores ≥ 50 who underwent a lumbar discectomy at one of 3 facilities between June 2010 and December 2017. (sdu.dk)
  • The surgical procedures used were microscopic lumbar discectomy (MLD), percutaneous endoscopic discectomy (PED), and micro-endoscopic discectomy (MED). (physionovo.de)
  • Today, lumbar discectomy is one of the most commonly performed elective operations in the United States. (medscape.com)
  • Lumbar discectomy is the most common operation performed in the United States for lumbar-related symptoms. (medscape.com)
  • The objective of this article is to review the current literature on lumbar disc herniations with contralateral radiculopathy and answer main questions regarding pathophysiological basis and best surgical approach. (researchgate.net)
  • This full color stock medical exhibit depicts traumatic right sided lumbar disc herniations with the subsequently negligent attempted left sided surgical repairs. (smartimagebase.com)
  • You see, depending on whose research you choose to believe, somewhere between 50% and 70% of the adult American population is walking around with low back (lumbar) DISC HERNIATIONS that they are completely unaware of ( HERE ). (doctorschierling.com)
  • The good news is most lumbar disc herniations will resolve without surgical intervention. (michaelwheelermd.com)
  • The category and magnitude of disc herniations can only be determined by advanced imaging, especially MRI and/or CT. (drtravisheckesblog.com)
  • However, some lumbar disc herniations are medical emergencies and should be treated with such non-natural treatments. (your-indianapolis-chiropractor.com)
  • Majority of disc herniations occur between the L4-L5 or L5-S1 vertebrae. (physicocityphysio.com.au)
  • Approximately 75% of disc herniations heal within 6 months, often sooner. (physicocityphysio.com.au)
  • Many disc herniations do not actually cause any symptoms, so an MRI scan that shows a herniated disc does not necessarily mean that the herniation is causing the pain. (disclv.com)
  • A laminotomy and medial facetectomy may need to be performed in upper lumbar levels or with posterolateral disc herniations. (aofoundation.org)
  • An MRI of the spine showed posterior disc herniations with peridiscal osteophytes. (homoeopathie.in)
  • Non-contained lumbar disc herniations show better non-surgical relief than contained discs. (mcmurraychiropracticsolutions.com)
  • Surgical treatment may be required in 1-3% of lumbar disc herniations. (memorialhospitalsgroup.com)
  • Most of the lumbar disc herniations can shrink or disappear spontaneously with physical therapy or over time. (memorialhospitalsgroup.com)
  • The vast majority of lumbar disc herniations can be eliminated by physical therapy methods without surgery. (memorialhospitalsgroup.com)
  • MRI is very sensitive in delineating lumbar disc herniations. (medscape.com)
  • Almost all patients with sciatica and disc herniations deserve a trial of medical therapy. (medscape.com)
  • The incidence of thoracic disc injuries is 1 in 1 million persons per year, and these injuries account for 0.25-0.75% of all disc herniations. (medscape.com)
  • Multiple thoracic disc herniations. (medscape.com)
  • A randomized, prospective and longitudinal study was conducted in 160 patients with a clinical and radiological diagnosis of uncomplicated lumbar disc herniation, which have more than six weeks of evolution. (medigraphic.com)
  • However, confirmation of the diagnosis requires advanced imaging, which is usually in the form of a lumbar MRI. (michaelwheelermd.com)
  • The diagnosis of lumbar disc herniation includes medical history coupled with a physical and neurological examination. (endoscopic-spine.com)
  • To confirm the diagnosis, your doctor may order an MRI to evaluate changes in the disc and spinal nerves. (endoscopic-spine.com)
  • MRI is required to make the diagnosis of herniated lumbar disc. (texasspineandneurosurgerycenter.com)
  • An MRI scan is usually needed to confirm the diagnosis and understand the location and degree of the herniation, and additional diagnostic tests may be needed to rule out other possible causes of the symptoms. (disclv.com)
  • Others make the diagnosis without evidence of disc disease on MRI. (medscape.com)
  • Linscott MS, Heyborne R. Thoracic intervertebral disk herniation: a commonly missed diagnosis. (medscape.com)
  • The pain usually starts when the discs lose fluid and become too compressed within the vertebrae. (ahlgrenspinemd.com)
  • That is because continuous motion also exerts pressure on the discs and the vertebrae. (ahlgrenspinemd.com)
  • The discs may be affected when there is unexpected twisting in the vertebrae. (ahlgrenspinemd.com)
  • The results of these scans will show any abnormalities, particularly in the vertebrae discs, which will reveal lumbar disc herniation. (ahlgrenspinemd.com)
  • The lumbar intervertebral discs are flat and round, present between the lumbar vertebrae and act as shock absorbers when you walk or run. (endoscopic-spine.com)
  • They think that long-term use has a supporting role to the waist and is not afraid to damage the lumbar vertebrae and muscles again. (waistsupportbrace.com)
  • There are round and flexible structures called discs between the body parts of the small vertebrae in the spine. (memorialhospitalsgroup.com)
  • Incorrect posture causes the muscles in the back-lumbar region to lose their flexibility, weaken, lose the physiological curvature of the spine, and increase the pressure on the discs between the vertebrae. (memorialhospitalsgroup.com)
  • and to determine if diseases of the lumbar vertebrae, fracture there was a relationship between subjects' and dislocation of the vertebrae, infectious psychological and personal characteristics. (who.int)
  • In both groups, surgery was performed on the ipsilateral side of the herniated disc. (researchgate.net)
  • Conclusions: Conventional lumbar disk surgery alone is sufficient for the ipsilateral side of radiologically demonstrated disk herniation in patients with bilateral leg pain. (researchgate.net)
  • Surgery for the disk herniation is often carried out to treat the sciatica. (doctorschierling.com)
  • The results of disc surgery in this patient group is successful. (qxmd.com)
  • Fortunately, both of these conditions are very rare, and most surgery for a lumbar herniated disc is an elective procedure. (your-indianapolis-chiropractor.com)
  • Workers Compensation Lumbar Disc Herniation Rehabilitation without surgery may include work with a physical therapist. (danmccormicklaw.com)
  • The Ahlgren Spine Orthopaedic Surgery team is fully-equipped and certified to treat herniated disc patients. (ahlgrenspinemd.com)
  • Like other minimally invasive lumbar spine surgery , this technique involves the use of tubular retractors. (texasspineandneurosurgerycenter.com)
  • The vast majorities of people with a lumbar disc herniation do not need surgery and will recover and return to their normal lifestyle within several weeks or months of conservative treatment. (disclv.com)
  • CONCLUSION: Lumbar disc surgery has a positive effect on sexual function and reduces pain levels. (erdogan.edu.tr)
  • Effects of propofol, desflurane, and spinal anesthesia on intraocular pressure during lumbar disc herniation surgery: a randomized controlled study. (bvsalud.org)
  • This study aims to evaluate the effects of total intravenous anesthesia ( propofol ), volatile anesthesia ( desflurane ), and spinal anesthesia on intraocular pressure (IOP) during lumbar disc herniation surgery in the prone position . (bvsalud.org)
  • The aim of this study was to determine the safety and outcomes of total disc replacement (TDR) as an outpatient procedure in the ambulatory surgery center (ASC). (medscape.com)
  • Is a Unilateral Surgical Approach Effective in Patients with Bilateral Leg Pain with Unilateral Lumbar Disc Herniation? (researchgate.net)
  • Group 1 (30 patients) had bilateral leg pain and unilateral lumbar disk herniation. (researchgate.net)
  • Interestingly, some patients can present with radicular symptoms on the opposite side of the disc herniation. (researchgate.net)
  • OBJECTIVE: To evaluate the efficacy of Huoxue Tongluo decoction plus acupuncture in the treatment of lumbar disc herniation and its effectiveness in improving the fun ctional recovery of the patients' affected joints and mitigating their pain. (iospress.com)
  • METHODS: In this prospective study, 110 patients with lumbar disc herniation enrolled in our Hospital from June 2019 to June 2021 were collected and randomized to receive either conventional treatment (control group) or Huoxue Tongluo Decoction plus acupuncture (study group). (iospress.com)
  • CONCLUSIONS: Huoxue Tongluo Decoction combined with acupuncture significantly offers a viable treatment alternative for lumbar disc herniation with promising treatment outcomes, mitigates patients' limb pain, and improves their lumbar function and sleep quality. (iospress.com)
  • This is how younger patients with healthy discs may develop a lumbar disc herniation. (outpatient-spine-surgeon.com)
  • These patients were then treated with long-lever rotation manipulations of the lumbar spine. (drtravisheckesblog.com)
  • The results of this study suggest that small disc protrusions were present in patients presenting with lumbago and that the protrusions were diminished in size when their symptoms had been relieved by manipulations. (drtravisheckesblog.com)
  • Physiotherapy is considered the primary conservative treatment for patients with disc herniation. (physicocityphysio.com.au)
  • One study found McKenzie exercises helped centralize pain in 62% of patients with lumbar disc herniation. (prophotoexpress.com)
  • One study found a core stabilization program significantly reduced disc herniation and improved function in patients. (prophotoexpress.com)
  • For most patients, a herniated disc heals on its own eventually. (ahlgrenspinemd.com)
  • L5-S1 herniation (between lumbar segment 5 and sacral segment 1)-May cause loss of the ankle reflex and/or weakness with ankle push off (e.g. patients cannot do toe rises). (disclv.com)
  • For most patients, symptoms from a lumbar disc herniation will go away over time. (disclv.com)
  • AIM: To compare preoperative and postoperative sexual dysfunction in male patients diagnosed with lumbar disc herniation (LDH). (erdogan.edu.tr)
  • The aim of this study was to determine the social impact of the patients suffering from lumbar disc herniation. (rcis.ro)
  • The study included 75 patients with lumbar disc herniation between the ages of 18-75, with the American Society of Anesthesiologists (ASA) 1-2. (bvsalud.org)
  • Unique features of herniated discs at the cervicothoracic junction: clinical presentation, imaging, operative management, and outcome after anterior decompressive operation in 10 patients. (medscape.com)
  • In patients with lumbosacral herniation, coughing, sneezing, and activities such as sitting and bending forward increase the pain. (msdmanuals.com)
  • The main indications are patients with soft tissue herniation inducing neuralgia resistant to 6 weeks of medical therapy and patients with stenosing soft tissue herniation inducing myelopathy. (medscape.com)
  • Outcome and cost-effective studies have shown the efficacy and improved benefits of the use of TDR for the treatment of degenerative disc disease (DDD) in a subset of patients. (medscape.com)
  • Degenerative lumbar disc herniation can happen over time due to the repetitive stresses put on the disc. (outpatient-spine-surgeon.com)
  • An CT scan of the lumbar spine may be done to check for fractures and degenerative changes of the spine. (outpatient-spine-surgeon.com)
  • Degenerative lumbar disc disease. (medscape.com)
  • The various forces placed upon the discs of the lumbar spine that can result in degenerative changes. (medscape.com)
  • Utility of machine learning algorithms in degenerative cervical and lumbar spine disease: a systematic review. (cdc.gov)
  • ACDF has however still remained the standard for treatment of degenerative disc disease. (medscape.com)
  • A series of images illustrate the Pre-operatvie condition of the disc to highlight the herniation on the patient's right side, the posterior incision over the lower back and steps from the surgical procedure as it is performed on the wrong side of the spine. (smartimagebase.com)
  • The surgical procedure to treat lumbar disc herniation is usually a microdiscectomy . (michaelwheelermd.com)
  • The conservative management of lumbar disk lesions should be given careful consideration because no patient should be considered for surgical treatment without first having failed to respond to an adequate program of conservative treatment. (drtravisheckesblog.com)
  • Microdiscectomy is the most commonly performed surgical procedure for lumbar disc herniation. (endoscopic-spine.com)
  • What are the non-surgical treatment methods for lumbar disc herniation? (memorialhospitalsgroup.com)
  • Surgical treatment of lumbar disc herniation no more effective than conservative treatment in competitive athletes. (physionovo.de)
  • In-office , Spinal Care Clinic uses Cox Technic Flexion Distraction and Decompression to lower the pressure in the disc so the nucleus pulposus returns to the center of the disc, aid in the healing of the torn anular fibers, and drive out chemicals that irritate and inflame the spinal nerves. (myspinalcareclinic.com)
  • In-office , Chiropractic Solutions use Cox Technic Flexion Distraction and Decompression to lower the pressure in the disc and aid in the absorption of the free nuclear material that is irritating the nerve. (mcmurraychiropracticsolutions.com)
  • Lumbar disc herniation occurs when the softer inner contents rupture backwards into the spinal canal. (michaelwheelermd.com)
  • This most frequently occurs at the L4-5 and L5-S1 levels, but disc herniation can occur at any level in the lumbar spine. (michaelwheelermd.com)
  • Disc herniation can occur during strenuous activity such as lifting heavy objects, but sometimes occurs during routine activity such as getting out of bed. (michaelwheelermd.com)
  • Lumbar disc herniation occurs when the cartilages in your lower back sustain damage. (ahlgrenspinemd.com)
  • As mentioned, a herniated disc occurs when the discs in between the spinal column get damaged. (ahlgrenspinemd.com)
  • A herniated disc occurs when the inner core (nucleus pulposus) of the intervertebral disc bulges out through the tough outer layer of ligaments that surround the disc (annulus fibrosis). (texasspineandneurosurgerycenter.com)
  • A lumbar (lower back) disc herniation typically occurs toward the back of the spine where there is a thinner boundary in the outer ring. (disclv.com)
  • Lumbar disc herniation occurs as a result of the discs protruding from where they should be. (memorialhospitalsgroup.com)
  • To obtain the largest window between the cranial and caudal lamina, tilt the C-arm to add 0-5° of kyphosis for the upper lumbar levels and 10-15° of kyphosis for the lower lumbar levels. (aofoundation.org)
  • In upper lumbar disc herniation (L1-2, L2-3), extending the leg at the hip with the patient prone can cause pain radiating into the anterior thigh (femoral stretch test). (msdmanuals.com)
  • The aim of the present study was to identify the effect of swimming on nerve root pain in rats with lumbar disc herniation (LDH). (iasp-pain.org)
  • The possibility of nerve root entrapment caused by lumbar disc herniation is high. (chison.com)
  • 3. On the 3rd day after admission, improve the lumbar spine MR prompt: the lumbar 5 / sacral 1 intervertebral disc plane can see the right posterior lateral protrusion of the intervertebral disc, thickening of the ligamentum flavum, hypertrophy of the articular process, narrowing of the lateral recess, and nerve root compression. (chison.com)
  • According to MR film, the lumbar intervertebral disc protrusion is not particularly serious, but the protruding part is just at the lateral recess, resulting in obvious nerve root compression and severe clinical symptoms. (chison.com)
  • This weak spot in the disc can be directly under the nerve root. (disclv.com)
  • (1) MRI helps in visualizing and monitoring the disc and nerve root changes while care is administered. (mcmurraychiropracticsolutions.com)
  • A disc herniation (lumbar disc disease) most frequently irritates the displaced nerve root. (medscape.com)
  • One of the more difficult concepts for beginning medical students to grasp is the anatomic relationship of the fifth lumbar (L5) nerve root to the L4-5 disc herniation. (medscape.com)
  • The perfect lumbar radiographs suggest that the lumbar 4 / 5 and lumbar 5 / sacral 1 intervertebral spaces are narrow. (chison.com)
  • The lumbar X-ray showed that the lumbar 4 / 5 and lumbar 5 / sacral 1 intervertebral spaces were narrow. (chison.com)
  • The selected points were lumbar 4 / 5, lumbar 5 / sacral 1 interspinous point, transverse process point, articular process point and piriformis muscle point. (chison.com)
  • Spine injuries can damage the spinal cord if they are at the upper portion of the lumbar spine or the lumbar and sacral nerve roots (cauda equina) if they are at the lower lumbar spine. (medlineplus.gov)
  • abstract = "Lumbar disc herniation (LDH) is one of the most common musculo-skeletal diseases. (elsevierpure.com)
  • Lumbar disc herniation, which can cause pain that will distract the person from their daily lives, can be successfully treated with physical therapy and rehabilitation applications together with medication treatments. (memorialhospitalsgroup.com)
  • Various methods such as injections and laser treatments are also used as part of the physical therapy and rehabilitation treatment of lumbar disc herniation. (memorialhospitalsgroup.com)
  • There are options such as medication and injection treatments, physical therapy and rehabilitation for the treatment of lumbar disc herniation. (memorialhospitalsgroup.com)
  • To evaluate the effect of treatment for pain due to lumbar disc herniation using pulsed electromagnetic fields. (medigraphic.com)
  • Ozone Therapy as a Treatment for Low Back Pain Secondary to Herniated Disc: A Systematic Review and Meta-analysis of Randomized Controlled Trials Pain Physician. (medigraphic.com)
  • Treatment for lumbar disc herniation depending on duration and severity of symptoms. (michaelwheelermd.com)
  • From what is known about the pathology of lumbar disk lesions, it would seem that the ideal form of conservative treatment would theoretically be a manipulative closed reduction of the displaced disk material. (drtravisheckesblog.com)
  • Now that we know what causes a lumbar disc to herniate, how do we find treatment? (your-indianapolis-chiropractor.com)
  • An injection into the lumbar spine can help control pain and inflammation if physiotherapy treatment is not progressing. (physicocityphysio.com.au)
  • Let's learn more about lumbar disc herniation and where you can go for effective treatment of this condition in Rochester Hills, MI. (ahlgrenspinemd.com)
  • Treatment for a lumbar disc herniation will largely depend on the length of time the patient has had his or her symptoms and the severity of the pain. (disclv.com)
  • The first three to four weeks of concentrated treatment, therapies, and at-home care are designed to allow the best opportunity for the disc to heal quickly. (myspinalcareclinic.com)
  • How is the treatment of lumbar disc herniation done? (memorialhospitalsgroup.com)
  • A lumbar disc herniation causes pain that spreads to the lower back and legs, while a cervical disc herniation causes pain that spreads to the neck and arms. (memorialhospitalsgroup.com)
  • The thoracic discs are unusually stable compared with the cervical and lumbar discs. (medscape.com)
  • However, the blood supply of the thoracic spine is more tenuous than the cervical and lumbar spine, especially at the T4-T9 watershed area, which is more prone to ischemic injury. (medscape.com)
  • Cervical total disc replacement (TDR) has advanced over the years with regular use of disc implants after 1995. (medscape.com)
  • According to the human body with the proportion of thoracic lumbar spine designed to extend the unique belt. (waistsupportbrace.com)
  • Thoracic disc injury, first described in 1838, is an uncommon site of injury owing to the stabilizing effect of the rib cage. (medscape.com)
  • The stability of the thoracic discs is secondary to the surrounding rib cage, with the stabilizing effect of the rib articulations. (medscape.com)
  • Therefore, the thoracic spine discs are at a decreased risk of injury because of the decreased bending potential in this segment of the spine. (medscape.com)
  • These 2 facts make the thoracic spine more sensitive to cord compression from disc herniation. (medscape.com)
  • Hidalgo-Ovejero AM. Thoracic disc herniation mimicking acute lumbar disease. (medscape.com)
  • Thoracic herniated discs: review of the literature and 12 cases. (medscape.com)
  • Preoperative localization of herniated thoracic discs using myelo-CT guided transpleural puncture: technical note. (medscape.com)
  • Ochronosis and lumbar disc herniation. (qxmd.com)
  • The spinal canal of the fifth lumbar vertebra is trilobal, and its lateral recess is the narrowest. (chison.com)
  • Check out what happens to the disc as it degenerates and herniates. (sitkabackpain.com)
  • Each disc is composed of a tough outer ring and a soft inner core, which is the part that extrudes, or "herniates" out. (disclv.com)
  • Acute (sudden) lumbar disc herniation can be caused by an injury, oftentimes by lifting something heavy using back muscles instead of leg muscles. (outpatient-spine-surgeon.com)
  • When the discs herniate in this area it can cause bowel and bladder incontinence, numbness in the groin or genital area, or sudden weakness in both legs. (outpatient-spine-surgeon.com)
  • A sudden severe trauma can also cause disc damage. (memorialhospitalsgroup.com)
  • It is best to seek natural, alternative methods before resorting to risky and dangerous surgeries to repair the disc or fuse the segment with metal plating. (your-indianapolis-chiropractor.com)
  • Shabat SH, Miller LE, Block JE, Gepstein R. Minimally invasive tratment of lumbar spinal stenosis with novel interespinous spacer. (medigraphic.com)
  • According to the clinical symptoms and MR results, it was considered as lumbar lateral recess stenosis. (chison.com)
  • Therefore, the deformation and protrusion of the intervertebral disc, the labial hyperplasia of the posterior edge of the vertebral body, the hyperplasia and hypertrophy of the lower joint, and the thickening of the ligamentum flavum can all lead to the stenosis of the lateral recess. (chison.com)
  • He had been suffering from what had been diagnosed, with the help of an MRI, as lumbar canal stenosis and disc herniation since 2000. (homoeopathie.in)
  • Lumbar canal stenosis maximum over L3-4 to L5-S1 level. (homoeopathie.in)
  • The outside of the disc is a tougher, fibrous material called the annulus fibrosus. (outpatient-spine-surgeon.com)
  • If the posterior longitudinal ligament and the annulus fibrosus are intact, some of this torsion force would tend to exert a centripetal force, reducing prolapsed or bulging disc material. (drtravisheckesblog.com)
  • As a disc degenerates, the inner core of the disc can extrude-or herniate-back into the spinal canal. (disclv.com)
  • In fact, the waist is only used in acute stage of lumbago, and when it is not painful, it may cause atrophy of lumbar muscles. (waistsupportbrace.com)
  • Factors that can put extra stress on the disc and speed up the process are aging, smoking and obesity. (outpatient-spine-surgeon.com)
  • Obesity, sedentary lifestyle and smoking increase the risk of lumbar disc herniation. (endoscopic-spine.com)
  • The center of each disc has a softer, jelly-like center called the nucleus pulposus. (outpatient-spine-surgeon.com)
  • The "contained disc" is a herniated disc in which the nucleus pulposus (the center of the disc) is contained within the anulus fibrosis (the outer layers of the disc). (myspinalcareclinic.com)
  • A herniated disk fragment comes from the nucleus pulposus of the disc (a remnant of the embryonic notochord). (medscape.com)
  • Magnetic resonance image of a herniated nucleus pulposus of the lumbar spine. (medscape.com)
  • Inter-vertebral discs have two components: the outer layer made of thick, dense, strong collagen and the inner material which is made of soft, spongy material. (michaelwheelermd.com)
  • In between each of the bones are round, spongy cushions called discs. (ahlgrenspinemd.com)
  • Between each vertebra there are gel-like discs that permit movement between the vertebra, cushion and absorb shock and transmit loads through the spinal column. (outpatient-spine-surgeon.com)
  • Mild disruption of the disc may result in lumbar disc degeneration . (sitkabackpain.com)
  • Smoking and increased rates of disk degeneration, with animal models showing increased proinflammatory markers, alterations to annular structure, vasoconstriction, and altered nutrient distribution to the disc. (medscape.com)
  • The bulging disc may even break open, releasing the gelatinous material, which is a chemical irritant, causing inflammation of the spinal nerves. (endoscopic-spine.com)
  • Alkaptonuria most prominently involves the lumbar region, but lumbar disc herniation as the presenting feature of alkaptonuria is not common. (qxmd.com)
  • It involves the removal of a part of the herniated disc that is causing nerve compression. (endoscopic-spine.com)
  • The authors also found similar trends in qualitative data as well as confirmed that symptom improvement was associated with disc regression. (nih.gov)