Application of Reabsorption Mechanism of Lumbar Disc Herniation in Clinical Rehabilitation

Lumbar disc herniation (LDH) is a leading cause of low back pain and radiating pain in the lower extremities. Spontaneous resorption following non-surgical management has been increasingly observed in some LDH patients. This process involves the partial or complete regression of the herniated disc, resulting in reduced compression on adjacent nerve roots and subsequent alleviation of clinical symptoms.This review systematically explores the multifactorial determinants influencing the resorption of LDH. These include individual factors such as age and gender, pathological characteristics such as the size and degree of herniation, and external factors including treatment modalities, the presence of Modic changes, lumbar sagittal balance parameters, and specific conservative interventions. Furthermore, we elucidate the underlying biological mechanisms driving resorption, encompassing immune responses, neovascularization, inflammatory reactions, dysregulation of matrix synthesis and catabolism, tissue dehydration, apoptosis, autophagy, and the tensile role of the posterior longitudinal ligament. Based on these insights, targeted rehabilitation strategies are proposed to promote disc resorption. These approaches focus on restoring physiological spinal curvature, strengthening the posterior longitudinal ligament, improving local disc microcirculation, facilitating inflammatory metabolism, and reducing edema. While the current understanding of the precise mechanisms and regulatory pathways of LDH resorption remains incomplete, future research should prioritize elucidating these mechanisms, developing predictive models for resorption potential, and identifying effective therapies to promote resorption. Large-scale, multicenter clinical trials are warranted to establish evidence-based guidelines that optimize conservative treatment outcomes for patients with LDH.