1.How many intervertebral discs are there in the human body? The structure of the human spine is very complex, and there are 32 vertebrae in the spine. Because there are no intervertebral discs between the circumferential thrust and the cardinal vertebrae and between the sacral caudal vertebrae, there are only 23 intervertebral discs in the whole body. They are all located between two vertebral bodies. The intervertebral discs in the lumbar region are the thickest, at about 9 mm. Lumbar discs are present from lumbar 1 to sacral vertebrae. People often say herniated disc actually refers to the lumbar disc protrusion, in fact, the cervical and thoracic vertebrae have intervertebral discs, can also be herniated, but the symptoms and signs, as well as treatment methods are different. 2.How many parts are there in the intervertebral disc? The intervertebral disc usually consists of three parts: the cartilage plate; the fibrous ring; and the nucleus pulposus. The intervertebral disc is actually a sealed container with cartilage plates on the top and bottom, which is transparent cartilage covering the vertebral body and the bone surface in the middle of the ring below. The upper and lower cartilage plates seal the nucleus pulposus together with the fibrous annulus. The fibrous ring consists of collagen bundles of fibrocartilage, which are located around the nucleus pulposus. The fiber bundles for fibers cross and overlap each other diagonally, making the fibular ring a solid tissue that can withstand large bending and torsional loads. The anterior side and sides of the fiber ring are thicker, while the posterior side is thinner. The anterior part of the fiber ring has strong anterior longitudinal ligaments, while the posterior side has narrower and thinner posterior longitudinal ligaments. Therefore, the nucleus pulposus tends to protrude posteriorly and compress the nerve roots or spinal cord. The nucleus pulposus is an elastic, gelatinous substance that is encapsulated by the fibrous ring and cartilage plate. The nucleus pulposus contains mucopolysaccharide protein complex, chondroitin sulfate and a large amount of water, with a water content of up to 90% at birth and about 80% in adulthood. 3.Does the structure of the lumbar disc change with age? The adult intervertebral disc tissue has no blood supply and relies on lymphatic infiltration to maintain nutrition, with only a small amount of blood supply to the surface of the annulus fibrosus. The intervertebral disc is the most heavily loaded part of the body. Therefore, after the age of 20, the lumbar disc begins to degenerate and the water content of the nucleus pulposus gradually decreases. Due to dehydration, the tension of the nucleus pulposus decreases and the disc becomes thinner. At the same time, the proteoglycan content of the nucleus pulposus decreases, collagen fibers increase, and the nucleus pulposus loses elasticity. The strenuous movement of the body can cause the layers of fibers of the annulus fibrosus to rub against each other and produce glassy changes, thus losing elasticity and finally leading to fiber rupture. Therefore, as the age line grows, the structure of the lumbar intervertebral disc ages and its elasticity and resistance to load decreases. 4.What are the functions of the lumbar intervertebral discs? The function of the lumbar disc is basically similar to that of the cervical and thoracic discs. The lumbar disc plays a special function in intervening in the spine to bear the weight of the trunk, linking the limbs, maintaining the normal physiological posture of the entire body, and carrying out various movements of the trunk, with the following specific functions: (1) maintaining the height of the spine and maintaining the height. (2) linking the upper and lower vertebrae of the intervertebral disc and providing a certain degree of mobility between the vertebrae. (3) Subjecting the surface of the vertebral body to the same force, even though there is still a certain inclination between the vertebral bodies, the entire disc is subjected to the same stress through the semi-liquid component of the nucleus pulposus. (4) Cushioning effect. (1) because of the elastic structure, especially the nucleus pulposus has plasticity, variable flattening under pressure, so that the force added to it can be transferred equally to the fiber ring and cartilage plate in all directions; (2) is the main structure of the spine to absorb shock, playing the role of elastic cushion, so that when falling from a high place or sudden load on the shoulder, back, lumbar, play a buffer role in force transmission, play a role in protecting the spinal cord and important nerves in the brain. (5) Maintain a certain distance and height of the lateral articular processes. (6) Maintain the size of the intervertebral foramen, which under normal circumstances is 3 to 10 times the diameter of the nerve root. (7) maintain the curvature of the spine, the thickness of the intervertebral disc varies in different parts, in the same lumbar intervertebral disc its front is thick, the rear is thin, so that the lumbar spine appears physiological convex curve. 5.What is lumbar disc herniation? The lumbar intervertebral disc degenerative changes or trauma caused by the rupture of the fibrous ring, the nucleus pulposus from the rupture, compression of the lumbar nerve root or cauda equina nerve, and a series of neurological symptoms such as lumbar leg radiological pain, called lumbar intervertebral disc protrusion (expansion) disease or lumbar intervertebral disc fibrous ring rupture disease. 6, lumbar disc protrusion (bulge) in which location? Lumbar disc protrusion (bulge) disease, more than 90% involves the lower two intervertebral spaces. This is because the lower two intervertebral spaces are heavily strained, degenerated and easily protruded, on the other hand, the lumbar 5 and sacral 1 nerves cross the lower two intervertebral discs respectively in the spinal canal, and when the discs protrude, the compression and pulling of the nerve roots produce typical clinical symptoms, which are easily detected clinically. By studying the clinical correlation between the height of the iliac crest interlaminar line and lower lumbar disc degeneration, it was demonstrated that the rate of disc degeneration in lumbar 5 sacral 1 or lumbar 4-5 was related to the position of the iliac crest interlaminar line. Those with high inter-iliac crest line had poor lumbar 5 sacral 1 degeneration and heavy lumbar 4-5 degeneration; those with low inter-iliac crest shallow had heavy lumbar 5 sacral 1 degeneration. In addition, most statistics show that lumbar disc herniation is easy to occur on the left side, mainly because most people in sports and labor, the right hand force, the right side of the lumbar back muscle tension is stronger, the corresponding pressure on the right side of the intervertebral disc is greater, the squeezing force is transmitted to the left side, can make the left side of the fibular ring tear, and the nucleus pulposus squeezed to the left side and cause protrusion. 7.Why is lumbar disc herniation easy to recur? Patients with lumbar disc herniation can be relieved or cured after treatment and rest, but the recurrence rate of the disease is quite high, and many patients are reluctant, but often become “repeat customers” who “visit” the doctor. The reasons for the high recurrence rate of the disease are as follows: (1) after treatment of lumbar disc herniation, although the symptoms basically disappeared, but many patients did not completely return to the nucleus pulposus, only the degree of compression of the nerve root has been alleviated, or the adhesion of the nerve root is lifted. (2) Although the condition of lumbar disc herniation patients has been stabilized or healed, but in a short period of time, once the strain or sprain of the lumbar can make the nucleus pulposus protrude again, resulting in the recurrence of the disease. (3) In the cold and humid season, the patient does not pay attention to the warmth, and the wind, cold and damp invade the diseased part of the body, and the strain may easily induce the recurrence of the disease. (4) Although the nucleus pulposus of the segment has been removed in postoperative patients, the stability of the vertebrae above and below the segment is poor after surgery, so the discs in the upper and lower segments of the operated segment are prone to prolapse, leading to the recurrence of lumbar disc herniation. 8.What kind of sitting posture should be taken by patients with lumbar disc protrusion (bulge)? From the cause of lumbar disc herniation, it can be seen that prolonged sitting or incorrect sitting posture is one of the causes of disc herniation, so what kind of sitting posture can be taken to minimize this risk? The correct sitting posture should be straight upper body, tucked in, jaw slightly tucked, and both lower limbs together. If possible, it is best to put a footrest or footstool under the feet so that the knees are slightly above the hips. If sitting on a chair with a backrest, it should be in the above posture on the basis of the back of the waist as closely as possible and lean on the back of the chair, so that the lumbosacral muscles are not too fatigued. After sitting for a long time should also be active to loosen the muscles of the lower limbs. In addition, lumbar disc protrusion (bulge) patients should not sit on a low stool less than 20cm, should sit on a chair with a backrest, because this can bear part of the weight of the body, so that the lumbar back is relatively in a relaxed state, reducing the chance of lumbar back strain. 9, bed rest of lumbar disc protrusion (bulge) how to get out of bed? Lumbar disc protrusion (bulge) disease patients during bed rest, may encounter some situations need to get out of bed, how to get out of bed to avoid excessive activity of the lumbar spine, reduce the burden on the waist? When the patient gets out of bed in supine position, the body is first carefully laid to the healthy side, i.e., the healthy side is underneath, both knees are semi-flexed, and the hand located above is held against the bed board, while the elbow joint below is used to support the semi-flexed upper body, with the force of these two fulcrum points, the patient will sit up more easily, and then use the hand to support the bed board, and use arm strength to make the body leave the bed, while the semi-flexed hip and knee joints are moved to the side of the bed, and then use crutches and other Then use crutches and other supports to support standing. Getting up according to the above method can make the trunk move as a whole, thus reducing the lumbar flexion, lateral flexion, lateral rotation and other movements, which will not cause pain or discomfort in the lumbar region. If the patient has difficulty getting out of bed alone, he can get out of bed in the same way with the help of family members. 10.What kind of sleep position is better for patients with lumbar disc protrusion (bulge)? The sleep position of human can be roughly divided into three ways: supine, lateral and prone. When lying on the back, as long as the lying apparatus is appropriate, the limbs remain naturally extended, and the spinal curvature does not change much. Side lying generally do not have to pay too much attention to the left or right side lying position, because people in sleep in order to get a more comfortable position, always turn over and over, about 20-45 times a night. Prone position when the chest pressure, lumbar convexity increased, easy to produce discomfort. Therefore, it is generally appropriate to take the supine and lateral position. Patients with conditions, supine position should be a soft pillow under both lower limbs, so that both hips and knees slightly flexed, the whole body muscle relaxation, disc pressure is reduced, reducing the tendency of disc protrusion, but also reduce the hip and waist muscles and sciatic nerve tension, which can effectively prevent the recurrence of lumbar disc protrusion (bulge) disease, is the best position for patients with lumbar disc protrusion (bulge) disease. 11.What are the benefits of using a lumbar girth for patients with lumbar disc herniation (bulge)? After the lumbar disc herniation (bulging) disease patients are bedridden or traction, doctors always ask patients to wear lumbar circumference, so what are the benefits of lumbar circumference for the treatment of lumbar disc herniation (bulging) disease? First of all, the main purpose of lumbar disc protrusion (bulge) patients wearing lumbar girth is braking, which is to limit the movement of lumbar intervertebral flexion, especially to assist the dorsal muscles to limit some unnecessary forward flexion movements to ensure that the injured lumbar intervertebral disc can be fully rested locally. Especially in patients with acute lumbar disc protrusion (bulge), due to the acute local inflammatory response and stimulation, there can be varying degrees of muscle spasm, after wearing the lumbar girth, reducing the activities of the waist, can play a role in strengthening the protection. The reasonable use of lumbar girth can also reduce back muscle strain, reduce the burden on the ligaments around the lumbar spine in a relaxed posture, and relieve and improve the pressure within the intervertebral space to a certain extent. After bed and traction after the patient began to get out of bed, each time the time is shorter, the amount of movement is less, and the range of motion should not be too large, at this time, wearing lumbar girth can keep the curve of the lumbar spine in a better state, which is good for strengthening the therapeutic effect. 12, wearing the lumbar girth precautions lumbar disc (bulging) herniation and other lower back disorders of patients, when wearing the lumbar girth pay attention to the following points: (1) the specifications of the lumbar girth to adapt to the length and circumference of their waist, the upper edge must reach the lower edge of the rib, the lower edge to the hip cleft. The back side of the waist circumference should not be too convex, to flat or slightly convex forward is good. Do not use too narrow waist circumference, so as not to overly convex lumbar vertebrae, and do not use too short waist circumference, so as not to abdomen too tight. Generally, you can try it on for half an hour first, so as not to produce discomfort. (2) Wearing the waist circumference can grasp the time according to the condition, when the waist symptoms are heavy, should be worn often, do not take it off at any time, light patients, can wear the waist circumference when going out, especially to stand for a long time or a posture sitting, and then take it off when sleeping and resting. After the symptoms have gradually subsided and the signs have gradually become negative, the waist circumference should be removed and the normal activities of the waist should be gradually resumed, generally the entire use time is 4 to 6 weeks. (3) After wearing the lumbar girth, attention should be paid to lumbar activities. Since the lumbar girth only restricts activities such as flexion but cannot reduce gravity, attention should still be paid to avoid excessive lumbar activities after wearing the lumbar girth, generally to complete daily life and work. For patients after surgery, serious lumbar fractures, dislocations, etc., lumbar activities should be carried out according to medical advice, and the release of the lumbar girth should also be approved by the doctor. (4) During the use of lumbar girth, the exercise of lumbar back muscles should also be gradually increased under the guidance of the doctor to prevent and reduce the atrophy of lumbar muscles. 13, lumbar disc herniation is common in whom? (1) Age: The disease occurs in people aged 25 to 50, accounting for more than 75% of the overall incidence. Although this age group is the young and strong period, but the degeneration of the intervertebral disc has already begun. (2) Gender: Lumbar disc herniation is mostly seen in men. This is because the proportion of men engaged in physical labor in social work is greater than that of women, and the lumbar spine load is also greater than that of women for a long time, which leads to more chances of inducing lumbar disc herniation. (3) Occupational aspects: This disease is common and prevalent in all walks of life, but it is still common in industries with high labor intensity. In addition, a large proportion of people who work in a sitting position for a long time also suffer from the disease. (4) Environmental aspects: people who work or live in a humid and cold environment for a long time are more likely to suffer from lumbar disc herniation. According to statistics, people who work underground in mines for many years have a higher percentage of this disease. (5) Other aspects: Is lumbar disc herniation related to genetic factors? There is no final conclusion yet, but it is certain that certain people with congenital dysplasia of the lumbar spine, such as those suffering from scoliosis and congenital spina bifida, have more chances of concurrent lumbar disc herniation. In addition, for example, women during pregnancy, due to special physiological reasons, resulting in sudden weight gain, combined with relative muscle weakness and ligamentous laxity, is also a dangerous time to induce this disease.