Which stages have the highest rate of spontaneous regression?

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Spontaneous regression happens when the body's immune system and phagocytes break down and resorb herniated disc material. When the nucleus pulposus has extruded through the annulus and into the epidural space, especially if a fragment becomes sequestered and detached, it has a large surface area exposed to blood supply, macrophages, and inflammatory mediators. This exposure drives more rapid enzymatic degradation and phagocytic clearance, so extrusion with sequestration regresses more often and more completely than other patterns. In contrast, contained protrusions remain within the annulus fibrosus and have limited contact with immune cells, making regression less likely. Degenerative changes are chronic and non-reversible by resorption, so they don’t undergo this spontaneous resolution. Thus, extrusion with sequestration shows the highest rate of spontaneous regression.