nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2015-1-61-65nnp-488Research ArticleCLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯRegression of lumbar disk herniationРегресс грыжи диска поясничного отдела позвоночникаЕвзиковГ. Ю.EvzikovG. YuИсайкинА. И.IsaikinA. I.alexisa68@mail.ruКавелинаА. В.KavelinaA. V.ШашковаЕ. В.ShashkovaE. V.АлипбековН. Н.AlipbekovN. N.Кафедра нервных болезней и нейрохирургии ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России, Москва, Россия; 119021, Москва, ул. Россолимо, 11 Клиника нервных болезней им. А.Я. Кожевникова ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России, Москва, Россия; 119021, Москва, ул. Россолимо, 11РоссияDepartment of Nervous System Diseases and Neurosurgery; 11, Rossolimo St., Moscow 119021 A.Ya. Kozhevnikov Clinic of Nervous System Diseases, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia; 11, Rossolimo St., Moscow 119021Russian FederationКафедра нервных болезней и нейрохирургии ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России, Москва, Россия; 119021, Москва, ул. Россолимо, 11РоссияDepartment of Nervous System Diseases and Neurosurgery; 11, Rossolimo St., Moscow 119021Russian FederationКлиника нервных болезней им. А.Я. Кожевникова ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России, Москва, Россия; 119021, Москва, ул. Россолимо, 11 
РоссияA.Ya. Kozhevnikov Clinic of Nervous System Diseases, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia; 11, Rossolimo St., Moscow 119021Russian Federation201520032015716165Copyright © Evzikov G.Y., Isaikin A.I., Kavelina A.V., Shashkova E.V., Alipbekov N.N., 20152015Евзиков Г.Ю., Исайкин А.И., Кавелина А.В., Шашкова Е.В., Алипбеков Н.Н.Evzikov G.Y., Isaikin A.I., Kavelina A.V., Shashkova E.V., Alipbekov N.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/488

Compression of the spinal nerve root, giving rise to pain and sensory and motor disorders in the area of its innervation is the most vivid manifestation of herniated intervertebral disk. Different treatment modalities, including neurosurgery, for evolving these conditions are discussed. There has been recent evidence that spontaneous regression of disk herniation can regress. The paper describes a female patient with large lateralized disc extrusion that has caused compression of the nerve root S1, leading to obvious myotonic and radicular syndrome. Magnetic resonance imaging has shown that the clinical manifestations of discogenic radiculopathy, as well myotonic syndrome and morphological changes completely regressed 8 months later. The likely mechanism is inflammation-induced resorption of a large herniated disk fragment, which agrees with the data available in the literature. A decision to perform neurosurgery for which the patient had indications was made during her first consultation. After regression of discogenic radiculopathy, there was only moderate pain caused by musculoskeletal diseases (facet syndrome, piriformis syndrome) that were successfully eliminated by minimally invasive techniques. 

Наиболее ярким проявлением грыжи межпозвоночного диска является компрессия спинномозгового корешка с развитием боли, чувствительных и двигательных расстройств в зоне его иннервации. При развитии подобных состояний обсуждаются различные варианты лечения, включая нейрохирургическое вмешательство. В последнее время накапливаются данные о возможности самостоятельного регресса грыжи диска. Представленно наблюдение пациентки с большой латерализованной экструзией, вызвавшей компрессию корешка SI с развитием выраженного мышечно-тонического и корешкового синдрома. Спустя 8 мес полностью регрессировали клинические проявления дискогенной радикулопатии, мышечно-тонический синдром, а также морфологические изменения по данным магнитно-резонансной томографии. Вероятный механизм – воспалительно-индуцированная резорбция крупного фрагмента грыжи диска, что согласуется с данными литературы. При первой консультации пациентки обсуждалось нейрохирургическое вмешательство, для которого были все показания. После регресса дискогенной радикулопатии сохранялась лишь умеренная боль, обусловленная скелетно-мышечной патологией (фасеточный синдром, синдром грушевидной мышцы), которая была успешно устранена малоинвазивными методами. 

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The authors declare that there are no conflicts of interest present.