Example of life Mr. Wan, a car driver, 46 years old, has been working in the bus company for nearly 8 years, and found out that he had lumbar disc herniation 2 years ago. At that time, the first left leg pain, and later appeared waist and back pain, the doctor let him sleep on a hard board bed, rest, take anti-inflammatory analgesic drugs, do massage, but also let him usually strengthen the lumbar muscles exercise. Due to busy work, usually do not have much time to insist on exercise, in February this year, due to driving sedentary lumbar and leg pain worsened, numbness of the left lower limb, walking inconvenience, seriously affecting the life and work. Had to go to a tertiary hospital again for examination, at this time has come to the point of having to operate. Doctor’s words lumbar disc herniation is due to lumbar disc degeneration, rupture of the annulus fibrosus, the nucleus pulposus protrudes to stimulate or oppress the nerve root, the cauda equina nerve manifested a series of sciatica clinical signs and symptoms, commonly known as “lumbar protrusion”, is a common clinical disease and the most common cause of lumbar and leg pain, often to the patient’s life and work, bring a lot of pain, and even cause disability. It often brings a lot of pain to the patient’s life and work, and even causes disability and loss of labor ability. The basic cause of lumbar synostosis is degeneration of intervertebral discs, but there are many triggering factors. One of them is occupational factors. For example, Mr. Wan, the car driver mentioned above, because of the bad posture of the waist when driving for too long, long-term sitting, bumps and vibration, the lumbar intervertebral discs are subjected to excessive pressure and repeated changes, which can accelerate disc degeneration and lead to herniation. Clinical manifestations of lumbar herniation The symptoms of lumbar herniation are varied, and most of the patients start with mild symptoms, which gradually worsen later. The main manifestations are: (1), lumbar pain. Lumbar pain is the first symptom of most patients with this disease, but there is no specificity. A few patients only have leg pain without low back pain. (2) Radiating pain in the lower extremities. It starts from the waist or buttocks and launches to the calf or heel, commonly known as sciatica. Any factors that increase abdominal pressure such as coughing, straining to defecate, laughing, sneezing, lifting heavy objects, etc., are likely to induce low back pain or aggravate the low back pain that has already occurred. (3) Restriction of lumbar activities. When the fibrous ring is not completely ruptured, the patient likes the forward flexion position and the backward extension is limited. The reason is that when the lumbar spine is flexed anteriorly, the ligamentum flavum between the vertebral plates is tensed, increasing the volume of the spinal canal and the space behind the intervertebral space, and the corresponding increase in the tension of the posterior longitudinal ligament makes the protruding nucleus pulposus partially return to the nucleus pulposus, which reduces the symptoms of nerve root compression. (4) Scoliosis. Postural compensatory deformity adopted by the patient to relieve pain. (5) Intermittent claudication. That is, after walking a certain distance, lower limb pain, weakness, stooping or squatting to rest after the symptoms can be relieved, and then walking symptoms reappear. (6) Numbness. Some patients with lumbar synostosis often experience numbness in the limbs, which is mostly caused by the intervertebral disc tissue compressing the proprioceptive and tactile fibers of the nerves. (7), serious lower limb muscle atrophy, paralysis, urinary and fecal incontinence. We often encountered in the clinic due to the delay of the patient, resulting in lower limb muscle paralysis, urinary and fecal disorders, at this time the operation is not ideal. Need to cause patients enough attention. Car drivers how to prevent the occurrence of lumbar herniation The incidence of lumbar disc herniation in drivers is relatively high, especially cab drivers or long-distance bus drivers. So, what measures can be taken to prevent the occurrence of lumbar herniation for automobile drivers? Adjust the seat, leaning back at an angle of 100 degrees, not too far back, which will increase the pressure on the lumbar region. Avoid driving continuously for more than one hour. When you need to drive for a long time, it is advisable to stop and rest for 5-10 minutes, and do some lumbar health exercises. Strengthen the functional exercise of neck and waist muscles, and participate in sports such as swimming. Try not to set the temperature of the cab too low, low temperature or cold can cause small blood vessel contraction, muscle spasm, so that the pressure of the intervertebral disc increases, which may cause degeneration of the intervertebral disc rupture. When the car breaks down and needs to be drilled under the car for repair, the legs should be flexed to reduce the burden on the waist. How to drive a car with lumbar spondylolisthesis Adjust the seat, try to keep the backrest and the seat at about 100 degrees The backrest of the seat should be placed against your lower back, so that the lumbar muscles can be supported. Adjust the height between the seat and the steering wheel. Wear a lumbar cushion while driving. Put a lumbar cushion on the seat. Slow down when driving over uneven road surfaces to minimize bumps. Treatment of Lumbar Syndrome Conservative treatment. More than 80% of patients can be relieved and cured by strict conservative treatment. The main ways are: bed rest, lumbar and dorsal muscles functional exercise, traction therapy, massage therapy, physical therapy, anti-inflammatory and analgesic drug therapy and so on. Surgery. After strict conservative treatment is ineffective, surgery is an effective method. The main programs are: minimally invasive treatment, simple nucleus pulposus removal, lumbar spine non-fusion technology (elastic fixation), lumbar spine fusion technology and so on. Specifically, different surgical options should be chosen according to the condition of different patients. In conclusion, automobile drivers are a high-risk group for lumbar synostosis, a disease that many people don’t pay much attention to, but when they have it, it will seriously affect their work and quality of life. Therefore, it is recommended that people with similar job nature, early prevention and early treatment. Never take it improperly. It is a medical opinion that people with lumbar deformity and past or present low back pain should not choose driving as a career.