Conservative management of an L4-L5 left nuclear disk prolapse with a sequestrated segment.

A case report is discussed in which a clinically diagnosed case of an L4-L5 nuclear prolapse with a sequestrated fragment was verified by computerized axial tomography and magnetic resonance imaging at the initiation of the treatment period. It was treated with flexion-distraction manipulation, hot and cold fomentation, positive galvanism, a lumbosacral support, nutritional supplementation, abstinence from sitting and exercises. Four wk after initiation of treatment, the patient was asymptomatic. Eight wk after initiation of treatment, and 6 wk after the original scan, magnetic resonance imaging verified a reduction in the size of the prolapse within the vertebral canal. An 11 month follow-up examination indicated the patient had no exacerbations of her condition and all objective findings were negative.