J Manipulative Physiol Ther. 1996 Jul-Aug; 19(6): 391-7.

The biomechanical significance of herniated lumbar intervertebral disk: a clinical comparison analysis of 22 multiple and 39 single segments in patients with lumbar intervertebral disk herniation.

Zhao P, Feng TY.

PLA Research Center of Traditional Chinese Manipulative Orthopedic, PLA Air Force General Hospital, 4th Surgery Dept., Beijing, P.R. China.

OBJECTIVE: To analyze the clinical significance of herniated lumbar intervertebral nucleus pulposus (HNP) inside the spinal canal. STUDY DESIGN: This was a comparison study between patients with multiple lumbar disk herniation and those with single lumbar disk herniation receiving conservative treatment. METHODS: Four indices, including computed tomography, plain and dynamic radiology and quantified physical examinations, were compared among 22 consecutive patients with multiple disk protrusions and 37 with single disk protrusion before and after a period of conservative treatment, mainly using spinal manipulation. RESULTS: There were no obvious changes of HNP size, position and volume, even after clinical improvement. However, structural and functional recovery in the group with multiple segments was less satisfactory than that of the group with single segment involvement. CONCLUSIONS: The protruded disk tissue plays an important role in the biomechanical disturbances of the spinal column besides that of an irritating agent to nerve root(s).