THE PATHOMORPHOLOGIC CHANGES THAT ACCOMPANY THE RESOLUTION OF CERVICAL RADICULOPATHY - A PROSPECTIVE-STUDY WITH REPEAT MAGNETIC-RESONANCE-IMAGING

Study Design. A prospective study with independent clinical and radiol ogic review. Objective. To assess whether regression of cervical inter vertebral disc herniations accompanied and correlated with clinical im provement in patients recovering from Cervical radiculopathy without u ndergoing surgical intervention. Summary of Background Data. The study subjects were 13 consecutive patients, nine men (69%) and four women (31%), presenting with, cervical radiculopathy. All patients but one h ad objective neurologic signs. All patients had large posterolateral c ervical intervertebral disc herniations demonstrated by magnetic reson ance imaging. Methods. Pain was controlled by serial periradicular and epidural corticosteroid injections. Patients were finally examined an d discharged from care because of sustained pain control at an average of 6 months (range, 2-12 months). They were interviewed subsequently over the telephone by an independent clinician and rescanned at an ave rage of 12 months (range, 4-31 months). The scans were reviewed by an independent radiologist masked to the sequence of the scans. Results. Regression of cervical disc herniations was. demonstrated in 12 of the 13 patients. All patients had made a satisfactory clinical recovery, but the one with the herniation that had not regressed suffered from p ersistent minor symptoms. Conclusions. Most cervical disc herniations regress with time and without the need for surgical resection. Thus, s urgical intervention can be avoided with adequate pain control, allowi ng the herniation time tb regress.