Surgical treatment of lumbar disc herniation

Lumbar disc herniation is one of the more common diseases, mainly because of the lumbar intervertebral disc parts (nucleus pulposus, annulus fibrosus and cartilage plate), especially the nucleus pulposus, there are varying degrees of degenerative changes, in the role of external factors, the intervertebral disc’s annulus fibrosus rupture, the nucleus pulposus tissue protrudes from the rupture place (or out) in the posterior or vertebral canal, resulting in the adjacent crural nerve root suffers from irritation or pressure, thus generating lumbar pain As a result, a series of clinical symptoms such as lumbar pain, numbness and pain in one or both lower limbs are produced. The incidence of lumbar disc herniation is highest in lumbar 4~5 and lumbar 5~sacral 1. Surgical treatments include: a posterior lumbar back incision, partial removal of the vertebral plate and synovial process, or discectomy of the disc through the intervertebral plate space. For central herniated disc, after laminectomy, extradural or intradural discectomy is performed. In the case of combined lumbar instability and lumbar spinal stenosis, concomitant crural fusion is required. Indications for surgery: ① more than three months of history, strict conservative treatment is ineffective or conservative treatment is effective, but often recurring and severe pain; ② the first attack, but the pain is severe, especially in the lower limbs, the patient is difficult to move and sleep, and in a forced position; ③ combined with the cauda equina nerve compression manifestations; ④ the appearance of a single nerve root paralysis, accompanied by muscular atrophy, muscle strength; ⑤ combined with the stenosis of the spinal canal.