Synergetic mechanism by decompression and bone bioactive factors to induce the spontaneous resolution of lumbar disc herniation

Spontaneous resolution represents an ideal therapeutic outcome for intervertebral disc herniation, a prevalent clinical disorder. Drawing on our prior cervical spine research, we have demonstrated that herniated disc tissue is absorbable, a process we term the induced resorption of herniated nucleus pulposus (iRHNP). We hypothesized that a synergistic microenvironment-combining mechanical force withdrawal (decompression) and the biological activity of bone healing (release of bioactive factors)-artificially drives iRHNP. This study employed integrated in vitro and in vivo models, including rat explant co-cultures and a rabbit laminoplasty model, to confirm disc volume reduction and associated matrix degradation. Based on this mechanistic insight, we developed a novel Resolution-Induction technique for Lumbar Disc Herniation (RI-LDH). A subsequent prospective clinical study verified the iRHNP phenomenon and its underlying mechanism. Our findings elucidate, for the first time, a synergistic "decompression + bone bioactive factors" mechanism. Patients treated with RI-LDH exhibited excellent clinical outcomes, correlating with symmetric spinal canal decompression, bony reconstruction, and significant iRHNP. This work establishes the foundation for a novel resolution-oriented therapeutic strategy for disc herniation.