Disc degeneration Tearing (rupture) of the fibrous ring with or without tearing of the posterior longitudinal ligament, compression of the nerve roots or relative reduction in the volume of the spinal canal, appearance of symptoms – Bilateral lower extremity symptoms – Cauda equina syndrome – Spinal cone syndrome – Peripheral cone syndrome – Cervicolumbar syndrome – Cold extremities – Tail pain – Calf edema – Other gait, spinal profile, lumbar mobility, pressure points, lower extremity muscles, muscle strength, sensation, reflexes, etc. Imaging tests include X, CT, MRI, electromyography, somatosensory evoked potentials, etc. The diagnosis of lumbar disc herniation is made based on the comprehensive clinical history, physical signs, and imaging tests. 3: nerve root tension test, 4: imaging: rare specific types are diagnosed as children and adolescents osteochondral scale dissection at the posterior edge of the vertebral body spinal stenosis combined with disc herniation elderly lumbar disc herniation high and multiple extreme lateral and foraminal types lumbar spondylolisthesis combined with disc herniation cervical and lumbar syndrome differential diagnosis is: 1 and low back pain differential – congenital bone development Abnormalities – Injurious diseases – Spinal tumors – Metabolic diseases – Inflammatory diseases – Degenerative diseases – Vascular and visceral 2 Differentiation from sciatica-like pain – Intraspinal tumors – Intraspinal arachnoid cysts – Lumbar spinal stenosis – Pyriform muscle syndrome – Diabetic peripheral neuritis – Others include, intermittent claudication, numbness and weakness of the lower extremities and psychiatric disorders Treatment Mainly non-surgical and surgical treatment includes Non-surgical treatment: – Bed rest – Medication – Traction – Tui-na – Acupuncture – Sealing – Indications for surgical treatment – history of lumbar disc herniation for more than six months, failure of conservative treatment, conservative treatment for at least 6 weeks but not more than 3 months, failure marked by no relief of pain, worsening of neurological symptoms or no improvement in straight leg raise test – severe pain – Single nerve root palsy or cauda equina symptoms, etc. – Middle age, long history of disease, interfering with work and life – Recurrent episodes despite success with conservative treatment – Disc herniation combined with other causes of spinal stenosis – Foraminal or extreme posterolateral Herniated disc Surgical approach – 1948, American lane and moor transabdominal resection of disc with fusion (eliminated) – 1967, American hodgson extraperitoneal approach (eliminated) – 1968, reported myelolysis with papain (largely eliminated abroad) In 1975, Japanese hijkakt reported percutaneous nucleus pulposus removal – In 1985, percutaneous puncture discectomy – In 1983, reported posterior lateral approach arthroscopic microdiscectomy ( – Laser decompression of disc nucleus pulposus in 1985 (largely eliminated) – Posterior approach endoscopically assisted disc removal in 1999 Indication for fusion (indication for internal fixation) – Discogenic low back pain – Intraoperative estimated resection of 50 disc herniation combined with lumbar spondylolisthesis – lumbar spinal stenosis combined with lumbar disc herniation – lumbar disc herniation after surgery – recurrence of the original stage – postoperative instability – all After resection PLIF,ALIF – Arthritis of the joint synapse Summary Lumbar disc herniation is a common disease, domestic and foreign research on this disease is more thorough, the treatment effect is also very accurate, the so-called paralysis and other nerve root complications are rare, the patient should choose the regular hospital consultation, the treatment effect is guaranteed, to believe in science, if there are diseases in this area can consult We, we will provide answers.