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Case Reports
. 2019 Jul;98(27):e16189.
doi: 10.1097/MD.0000000000016189.

Nonsurgical integrative Korean Medicine treatment of discal cyst: A case report and a retrospective chart review analysis

Hee-Seung Choi  1   2 , Sook-Hyun Lee  3 , Yoon Jae Lee  3 , In-Hyuk Ha  3
Affiliations
Case Reports

Nonsurgical integrative Korean Medicine treatment of discal cyst: A case report and a retrospective chart review analysis

Hee-Seung Choi et al. Medicine (Baltimore). 2019 Jul.

Abstract

Rationale: Discal cysts are rare lesions characterized by pain caused by neurogenic compression with similar symptoms as those of disc herniation. This study aims to report the spontaneous regression of discal cyst achieved through nonsurgical integrative Korean Medicine treatment and the clinical epidemiological features of discal cyst cases collected from 4 institutions.

Patient concerns: A 31-year-old woman had low back pain and radiating pain equivalent to a numeral rating scale (NRS) of 8 and had limitations in daily work and activities.

Diagnoses: The patient was diagnosed as having discal cysts that compressed the left S1 based on findings of L-spine magnetic resonance imaging (MRI) performed at our hospital.

Interventions: The patient received nonsurgical Korean Medicine treatment and after 24 days of treatment in the hospital, she underwent 16 additional treatments as an outpatient.

Outcomes: Spontaneous regression was confirmed in the L-spine MRI follow-up at 36 days and 99 days after the initial test, and the patient underwent once-a-week follow up to examine NRS, Oswestry Disability Index (ODI), EuroQol-5 Dimensions (EQ-5D), and fear-avoidance beliefs questionnaire (FABQ) after 4 weeks, and 2, 3, and 6-month follow-ups after that. The patient was discharged in a painless condition, and she was able to carry on for 5 months without increased pain.

Lessons: Discal cysts are more rapid progress than disc herniation, it seems valid to attempt nonsurgical treatment. Epidemiologically, this is the first study to present the clinical epidemiological characteristics of discal cysts, it would provide valuable information to clinicians who treat and study discal cysts.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Process of discal cyst resorption shown on T2-weighted MRI [A, D]. Confirmed that presence of discal cyst at L5-S1 is compressing the left S1 nerve root at initial Examination [B, E]. Confirmed remarkable spontaneous regression at first f/u on day 36 [C, F]. Confirmed resorption of discal cyst at second f/u on day 99. MRI = magnetic resonance imaging.
Figure 2
Figure 2
Clinical outcome timeline with assessment indices presented as percentages. EQ-5D = EuroQol-5 Dimensions, FABQ = fear-avoidance beliefs questionnaire, LBP = low back pain, Lt = left, NRS = numeral rating scale, ODI = Oswestry Disability Index.
Figure 3
Figure 3
Flow chart of a multi-center clinical epidemiological survey.
See this image and copyright information in PMC

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