Slow Selective Resorption of Multilevel Intervertebral Disc Herniation: A Multi-Image Case Study

Abstract

Introduction:
Spontaneous reduction of lumbar disc herniation has been increasingly reported, with inflammation-driven mechanisms considered a key factor. Conservative management, combined with patient education and modern physiotherapy, may support this natural healing process.

Material and Methods:
A 16-year-old female presented with progressive lumbar radiculopathy and was diagnosed with three large disc herniations from L3 to S1. Initial conservative treatment with NSAIDs and standard physiotherapy was ineffective, and a follow-up MRI showed enlargement of all herniations. A modified therapeutic approach emphasizing soft tissue therapy, neuromobilization, postural correction, and reduced anti-inflammatory use was introduced.

Results:
Within one month, the patient demonstrated marked improvement in pain, posture, and mobility. After six months, gait normalized and symptoms resolved. Follow-up MRI at 18 months revealed substantial regression of herniations at L3–L4 and L4–L5, with unchanged morphology at L5–S1. Clinical improvement preceded radiological changes.

Conclusions:
This case highlights the potential for delayed, segment-selective spontaneous regression of multilevel lumbar disc herniation following tailored conservative treatment. Understanding the role of inflammation and avoiding excessive suppression may support natural resorption processes. Conservative management should be considered a viable first-line option, particularly in young patients.