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Case Reports
. 2022 Apr-Jun;13(2):100561.
doi: 10.1016/j.jaim.2022.100561. Epub 2022 Jun 2.

Conservative management of acute prolapsed inter-vertebral disc with ayurveda: A case report

Shailesh V Deshpande  1 , Vaishali S Deshpande  2 , Ashutosh Bhosale  3 , Maruti Kadam  4
Affiliations
Case Reports

Conservative management of acute prolapsed inter-vertebral disc with ayurveda: A case report

Shailesh V Deshpande et al. J Ayurveda Integr Med. 2022 Apr-Jun.

Abstract

Acute prolapsed inter-vertebral disc (IVDP) is a painful condition that requires immediate treatment by conservative or surgical management. Though majority of patients show remission in symptoms with conservative treatment, regression of herniated disc with non-surgical management has been rarely reported. A 46 years old female patient with acute and severe low back pain, disability and radiating pain towards right lower extremity came to our hospital. Oswestry Disability Index (ODI) score of the patient was 94% indicating bed-ridden condition. MRI of lumbar spine showed diffuse posterior disc bulge between fourth and fifth lumbar vertebra indenting right traversing nerve root and inferior displacement of extruded disc along the body of fifth lumbar vertebra. She was treated according to treatment explained in Ayurveda. She received oral medications, application of medicated oils, fomentation and medicated enema (Basti). After treatment of seven and half months, the patient showed good remission in pain, stiffness and radiculopathy. ODI score reduced to 9% that indicates minimal disability. Follow up MRI showed non significant compression of the nerve root and gross reduction in the inferior displacement of extruded disc. Acute IVDP can be successfully conserved using Ayurveda treatment. The Panchakarma procedures and medicines used in the treatment need further evaluation.

Keywords: Ayurveda; Basti; Case report; Herniated disc; IVDP; Panchakarma; Sciatica.

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Figures

Fig. 1
Fig. 1
Coronal view of T2 weighted images of MRI of lumbosacral spine revealed diffuse posterior bulge and right paracentral extrusion of intervertebral disc between fourth and fifth lumbar vertebra causing indentation on thecal sac (arrow 1), narrowing of bilateral neural foramina and indenting right traversing nerve root (arrow 2).
Fig. 2
Fig. 2
Sagittal T2 weighted images showed the inferior displacement of extruded disc (8 × 5 mm) along the L5 vertebral body.
Fig. 3
Fig. 3
Coronal view of T2 weighted images of follow-up MRI showing mild posterior disc bulge between fourth and fifth lumber vertebrae causing indentation of the thecal sac (arrow 1), but there was no significant compression of the exiting nerve roots (arrow 2).
Fig. 4
Fig. 4
Sagittal view of T2 weighted images showed gross reduction in the inferior displacement of extruded disc (4 × 3 mm) along the L5 vertebral body.
See this image and copyright information in PMC

References

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