Tratamiento no quirúrgico con plasma rico en plaquetas y tracción mecánica lumbar de una hernia de disco lumbar. Reporte de caso

Abstract

We present the case of a 34-year-old woman who presents with severe low back pain and left radiculopathy due to two herniated discs, one at L4-L5 and the other at L5-S1, causing severe stenosis of the spinal canal and bilateral compression of the nerve roots with left predominance. Following a minimally invasive conservative management plan of 2 applications of platelet-rich plasma, lumbar traction therapy, and swimming, the patient experienced significant pain relief, functional improvement, and near resolution of deficits. A follow-up MRI at five months revealed resolution of the disc protrusion at L4-L5 and L5-S1, and the patient remained asymptomatic at one year. This case highlights the potential for resorption of a lumbar disc herniation and symptomatic improvement with minimally invasive conservative management, comprehensively including platelet-rich plasma treatment, traction therapy, and physical exercise. A natural course of a herniated disc should be considered when deciding between early surgical intervention and conservative treatment, warranting further prospective studies to evaluate the effectiveness of a comprehensive conservative and minimally invasive protocol and the role of spontaneous regression in symptomatic lumbar disc herniation.