ArticleCureus2025
Contrast-Enhanced Magnetic Resonance Imaging (MRI) as a Prognosticator for the Conservative Treatment of Lumbar Disc Prolapse: A Prospective Observational Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
9 authors.
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Abstract
introductionLumbar disc herniation (LDH) is a common spinal pathology, often managed conservatively. However, predicting which patients will show spontaneous resolution versus persistent symptoms remains a clinical challenge. This study aims to evaluate the role of contrast-enhanced magnetic resonance imaging (MRI) in predicting the natural history of disc prolapse and correlating it with clinical improvement. Materials and methods: A prospective observational study was conducted involving 50 patients between the ages of 18 and 65 years who have been undergoing treatment for the primary diagnosis of LDH. Patients were enrolled if they have partial relief of symptoms at the end of 6-8 weeks of conservative trial. All participants underwent contrast-enhanced MRI to evaluate the presence of rim enhancement. A clinico-radiological correlation was performed based on whether or not rim enhancement was observed on the contrast-enhanced MRI. Results: Among the 44 patients who had contrast enhancement on MRI, 42 patients (95.5%) showed a good clinical outcome at the time of final follow-up as measured by the visual analog scale (VAS) score. Among the total group, six patients (12%) required a surgical procedure for relief of their symptoms, and the majority of these patients, four out of six (66.7%), were those who had failed conservative management without any contrast enhancement on MRI.
conclusionContrast-enhanced MRI can serve as a powerful diagnostic adjunct in patients with incomplete symptom resolution during the conservative management of LDH. The presence of peripheral rim enhancement may predict favorable spontaneous resolution, enabling clinicians to make informed decisions regarding continued non-operative treatment versus surgical referral.
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