Using serial MRI, we studied 32 patients with herniated lumbar discs,
treated conservatively, to clarify the natural history of this conditi
on. MRI was performed in the acute stage, then 6 months and 1 year lat
er. On axial images, the proportion of the cross-sectional area of the
spinal canal occupied by the herniated disc was 31.9% on the average
on the initial scan, 28.7% 6 months and 25.3% 1 year later. The size o
f the herniation decreased by more than 20% in 11 patients (34%), by 1
0-20% in 8 (28%) and was unchanged in 12 (38%). The height of the disc
slightly decreased with time, but there was no significant change in
the angle of lordosis in the affected segment. The initial MRI reveale
d degeneration of all affected discs, and progressive degeneration was
observed in 9 patients. The more degenerate the disc and the larger t
he initial herniation the more the size of the herniated fragment decr
eased.