Non-surgical Management of Giant Tumor-like LDH

This is a retrospective observational study carried out at the Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine (Jiangsu, China) from March 2011 to June 2020. Eight patients with giant tumor-like LDH who had resorption after non-surgical treatment formed the basis of this study. The clinical data, including clinical symptoms, MRI images, Japanese orthopaedic association (JOA) score before and after treatment, “bull’s eye” sign classification, follow-up time, time of resorption and other clinical data were collected from case notes. According to the clinical symptoms and MRI imaging findings, these 8 patients were diagnosed as giant tumor-like LDH. We adopted a non-surgical treatment plan for the patients, including taking oral non-steroidal anti-inflammatory agents and performing rehabilitation exercise. In consideration of the risk of irreversible neurological damage which could be caused by long-term non-surgical treatment, patients are closely observed during treatment and follow-up. Once the following conditions occur, surgical treatment is required immediately ^{[8 (link)]}: The symptoms are not signifcantly relieved after 3 to 6 months of non-surgical treatment; The symptoms are aggravated by non-surgica treatment; The clinical manifestations of cauda equina syndrome.