Computed tomographic follow-up study of 21 cases of nonoperatively treated cervical intervertebral soft disc herniation.

The authors studied the natural evolution of cervical soft disc herniations in 21 patients with cervical radiculopathy that was successfully treated with conservative therapy only. The first computed tomography (CT) examination was performed during the acute phase of the radiculopathy, and the second performed from 1 to 30 months after healing. The initial CT allowed classification of the herniations according to size: nine were considered small, seven medium, and five large. Comparison with follow-up scans showed that five of the herniations decreased between 0 and 35%, six decreased between 35 and 75% and ten decreased between 75 and 100%. The largest herniations were those that had the greatest tendency to decrease in size. This tendency could be secondary to the herniation breaking through the outer fibers of the anulus and entering the epidural space.