Which stage is most likely to regress completely with natural history?

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Resorption of herniated disc material by the body’s inflammatory response is the idea here. A sequestered disc fragment is completely detached from the parent disc and lies free in the canal, which makes it highly accessible to macrophages and inflammatory mediators. This drives enzymatic breakdown and phagocytosis, so the fragment can shrink or even disappear completely over time, leading to full symptom resolution with natural history.

In contrast, tissue that remains bulging but attached to the main disc (protrusion or prolapse) or tissue that has herniated but still connects to the disc (extrusion) is less prone to complete resorption. They can improve, but complete disappearance is less predictable. Degeneration, being a chronic, progressive process of disc aging and hydration loss, doesn’t typically reverse completely.