Herniated disc is one of the most popular diseases in the world today, and it is also one of the most fashionable and striking diseases in China now. Originally a surgical disease, but neurology, physiotherapy, chiropractic or massage, analgesia or anesthesia and other medical disciplines have also flocked to a variety of medical points of view of the greatest controversy a disease. “Intentional planting of flowers does not work, but the willow will grow”. This article intends to present some reflections on the modern diagnosis and surgical treatment of herniated discs, and considers that traditional Chinese medicine is worthy of attention. Michael E. Debakey, an American surgeon, has pointed out that modern American surgery has gone through three “R’s”, i.e., from “resection” (resection) to “repair” (repair), and then to “repair” (repair). “(repair), and then “replacement” (replacement). The first and foremost reflecting this glorious development of surgery should be the diagnosis and surgical treatment of herniated discs! A Brief History of Surgery says: “On December 31, 1932 Barr and Philip Wilson performed the first operation on a patient with a preoperative diagnosis of ‘ruptured disc’ and on September 30, 1933 they presented their observations at the New England Surgical Society. They reported their observations at the New England Surgical Society on September 30, 1933, and thus began the ‘disc era’.” [1] In 1934, Mixter WJ and Barr JS surgically confirmed 19 patients with low back pain attributed to herniated disc nuclei and named them “ruptured discs.”[2] Mixter suggested, “Without the many scholars in neurosurgery, pathology, Mixter suggested that “it would not have been possible to focus on disc injury and its role as a major spinal disorder without the results of many scholars in neurosurgery, pathology, neurology, and orthopedics”. This “contribution” to medicine has been credited with creating the so-called “dynasty of the disc”. In 1764 a doctor named Domenico Cotugno gave a classic description of sciatica… …”[1]. It was also reported that “low back pain was also a rare condition during the First World War” [3]. “Until the second half of the 1970s, most patients with low back pain often visited internal medicine offices and were not very popular, called “haunted back (demon)”. The sciatica associated with herniated discs was only diagnosed before surgery was dared, and any other low back disorders were mostly avoided. Usually low back pain patients were pushed to chiropractors or massage doctors to handle, and no one in other departments seemed to have a keen interest in them. Physicians were not interested in low back pain, and there really was little scientific basis for clinical practice in the spine. It wasn’t until the 1980s with the advent of advanced imaging techniques, newer spine surgery techniques, and the rise of a training boom for specialized spine surgeons. Only then did the spine industry begin to flourish. Patients with low back pain, which used to be a burden for many doctors, now became a “gold mine” (gold mine.) Membership in spine societies skyrocketed and surgery rates peaked, with growth rates of more than 110% in some places. …… And unsuccessful surgery suddenly became a medical problem again, as if it were a new disease in itself – the failed surgery syndrome” [4]. It is evident that the “disc dynasty” had a process from its creation to its peak and downhill. Is surgery the best treatment for herniated discs? After more than 70 years of clinical practice, what should be the evaluation of this “disc dynasty” started in the United States? With the continuous development of imaging such as X-ray, CT and MRI, there are more and more reports of herniated discs in asymptomatic people. According to foreign data, 35.4% of the lumbar spine of asymptomatic volunteers examined by CT had herniated discs; 17% of the lumbar spine of asymptomatic volunteers examined by MRI were under 40 years old, 22% were between 40 and 59 years old, and 36% were over 60 years old. In the oldest group, 21% had spinal stenosis without symptoms [5]. This is only examining one part of the lumbar spine; if the entire spine is examined, the rate may be higher. This is why the American Orthopaedic Journal lists any disc herniation without symptoms or symptoms not consistent with the level of herniation as a contraindication to surgery (operation should not be done if no pain is present) [6]. The natural history of sciatica is predominantly that of spontaneous improvement. According to Hakelius, 38% of patients treated with bracing and rest alone improved within 1 month According to the Hakelius study, 38% of patients improved within 1 month with bracing and rest alone; 52% improved within 2 months, and 73% improved within 3 months. Another study (Natural history of lumbar disc hernia with radicular leg pain: Spontaneous MRI changes of the herniated mass and correlation with clinical outcome journal of orthopaedic medicine) was conducted. outcome journal of orthopaedic surgery,jun 2001): in their 42 patients treated conservatively for 3-12 months after symptom onset with MRI scans, 37 out of 42 patients (88%) showed effective (>50%) reduction of the herniated mass by more than 50% (37 out of 42 patients (88%)). effective (>50%) reduction of the herniated mass on MRI 3-12 months after the onset of symptoms). It was also reported by Saal and Saal that: more than 90% of patients with herniated discs with radiculopathy were successful with non-surgical treatments [6]. “I believe continued efforts in the area of minimally invasive techniques and nondestructive reparative therapy can be found. nondestructive reparative therapies must be sought”. As early as 1986, the New England Journal stated, “In the past 30 years, the confidence of diagnosticians, the enthusiasm of surgeons, and the legitimacy of publicly funded reimbursement have been greatly diminished. The cause of almost all limited low back pain is uncertain, and many abnormal pathologies, including disc herniation, are common in the spine of asymptomatic individuals, and attributing a single episode of low back pain to a specific anatomic abnormality is not sufficiently robust (tenuous). More than 80% of patients heal or improve significantly within 2 weeks, and most others will soon heal if they are actively encouraged or follow proper medical advice [3]”. Obviously this is a strong rebuke to those who overemphasize surgical treatment of herniated discs, i.e., the death knell for the “disc dynasty”! The spine is the foundation of health. The intervertebral discs are an integral part of the spine and help absorb stress and strain transmitted to the vertebral column, among other important physiological functions. Because of the hard work of life, over time, over time, causing a little damage or protrusion of the intervertebral disc, or even some symptoms of back and leg pain, are normal, no need to stress, if because of a little protrusion will be the entire disc “cut”, “repair” or replaced with If the entire disc is “cut”, “repaired” or replaced with an “artificial disc” because of a small protrusion, destroying the stability of the spine is like opening Pandora’s box [Note: A box that Zeus asked Pandora to bring to Euphemotus in Greek mythology. Pandora took the liberty to open it, and all kinds of misfortune inside flew out together. Now it refers to the source of all the calamities], then the loss will not be worth the gain, and from then on it will bring endless misfortunes to the patient. With the development of modern imaging, more and more people are diagnosing “herniated discs”, so it is important to have a clear understanding of them. Is the technology used to treat herniated discs in the United States so brilliant? “Today, there are two things that light up the human world: the sun in the sky and the United States on earth” (Wang Cheng). There is more than one Zhang Gongyao in China today who blindly worships American civilization! The current diagnosis and treatment of herniated discs in China can be described as problematic, and doctor-patient disputes or accidents are commonplace. Some people are very nervous once they are diagnosed with a “herniated disc” and think they are suffering from “immortal cancer”, so they run around seeking medical help. Some people have completely disappeared after conservative treatment, but CT re-examination still has “herniation”, so they think “invalid” and wrongly believe that only “surgery to remove the nucleus pulposus” is “The root of the problem” and willing to receive a knife even if there are no symptoms! “American equipment”, “American technology”! Some medical units take advantage of the patient’s ignorance of the function of the intervertebral disc and advertise “what is the best way to treat a herniated disc”, blatantly ignoring the fact that the vast majority of herniated discs can heal themselves and destroying the intervertebral disc tissue. The minimally invasive therapy that destroys disc tissue is advocated as the best treatment method: “after electricity is applied, the nucleus pulposus is vaporized and absorbed through low-temperature ablation, and cooling and shrinking” “should be the first choice at present”! Or “Ozone nucleus pulposus ablation, for example, uses a fine needle to puncture into the intervertebral disc and injects a small amount of ozone gas to dehydrate and shrink the nucleus pulposus to achieve the purpose of decompression of the intervertebral disc”! Claim: “The hospital has formed a series of ‘conservative, minimally invasive and open’ services in the treatment of cervical and lumbar disc herniation, covering nucleolysis, excision and suction, ozone (O3), discoscopy, two-overlap and three-overlap …… The “treatment plan”, the destruction of normal disc nucleus pulposus tissue as the first priority, and this “specializing in the treatment of herniated disc branch” is also “medical insurance and Ping An Insurance of China designated hospital”. “This technique has been included in the Category A single-patient billing program (medical insurance reimbursement) since June 1, 2006”, is the medical insurance department not aiding and abetting? What are the consequences for the country and its people if it spreads to the whole country? What do American experts think about the surgery? Dr. Michael E Goldsmith says, “Persistent pain or pain recurrence after lumbar surgery is a challenging topic in the field of spine surgery. …… Now, approximately 15% of patients undergoing lower back surgery do not experience complete relief after the initial surgery, which has led to an increase in spinal revisions each year. While 85% of patients experience symptomatic improvement after the initial procedure, the rate of remission after the second procedure is only 50%, and the rate of improvement continues to decline with each successive procedure. These numbers illustrate the importance of avoiding unnecessary surgery.” [7] In the case of intervertebral disc surgery, the indications for surgery are now demanding even in the United States. Many orthopedic surgeons have gradually become accustomed to treating under the conventional guidelines (guideline), namely the AAOS/North American Spine Society’s list of diagnoses and treatments for lower back pain [8]. The American journal SPINE suggests that “the spine association must stand on its heels. The NASS-led spine association must apply its knowledge, experience, and the accumulated resources of the spine association to establish a new model of spine care. The new model must be based on quality assurance and effective patient care. Unnecessary surgical procedures must be limited, complications reduced, and reoperation rates limited. In the opinion of ……, the new spine model should employ specially trained non-surgical specialists as gatekeepers for the management of musculoskeletal disorders. The system recommends that primary care for musculoskeletal disorders begin with a non-surgical specialist who will manage the patient; a specially trained and experienced spine surgeon should see the patient only when surgery is indicated, and the decision should be made by the non-surgical specialist. A non-surgical specialist may be a specially trained physical therapist, orthopedic surgeon, neurosurgeon, neurologist or rheumatologist. This separate training that specifically has a pivotal role in charge is absolutely essential” [4]. In his book, “Talking About Sickness and Pain – Human Experience of Suffering and Healing”, Dr. Kaberman describes an American police officer, Howard Harris, who suffered from low back pain. Harish’s painful experience with low back pain: “He saw several dozen doctors in almost every specialty: orthopedic surgeons, neurosurgeons, neurologists, anesthesiologists see Mrs. specialists, internists, family medicine doctors, rehabilitation specialists …… other health professionals: practicing nurses, rehabilitation therapists, acupuncturists, medical hypnotherapists, and specialists in biofeedback, meditation, behavioral medicine, massage, and hydrotherapy. He has attended pain clinics, pain classes and pain meetings, and he has read medical and self-help books on low back pain. Having had four major surgeries on his spine and feeling worse each time, Officer Harriss was worried and scared about having a fifth surgery”. As a result, his “whole life was pain” due to low back pain. …… If you don’t treat it properly at the beginning, you’ll be left with endless problems! What do you think about “nerve root compression by herniated disc”? Because CT or MRI reports often include diagnoses such as “herniated disc compressing nerve root”, “compressing dural sac” or “compressing spinal cord”, there are many medical patients who put Therefore, many medical patients regard “disc compression” as the main problem. In fact, this “compression mechanism” is just a doctrine. Some people have raised suspicions long ago, such as autopsies, some of the deceased have a large degree of disc herniation and posterior protrusion, but never had a history of low back pain before death (Fernstr?nm). Other different theories have been put forward: for example, Wall (1974) argued, based on the gate control theory, that “the principle of pain caused by lumbar disc herniation is still unknown.” Rothman (1977) suggested that “chemical irritants are a major pathogenesis of nerve root pain, and that pain does not occur with normal nerve root compression but only with sensory abnormalities; only inflammatory nerve root compression causes pain.” and Mashall (1977) proposed the theory of chemical radiculitis. Gertzbein (1977) also proposed the autoimmune theory. Based on his clinical practice for more than 50 years, our scholar Hsuan-hsing proposed a new theory and treatment: “The theory of pain caused by aseptic inflammation of soft tissues was created to replace the traditional fallacy of pain caused by mechanical compression, and the existence of herniated lumbar discs with non-painful factors was disregarded in the diagnosis, and soft tissue damage outside the spinal canal or mixed soft tissue damage inside and outside the spinal canal was used to replace the traditional ‘lumbar spinal pain’. Instead of the traditional misdiagnosis of ‘lumbar disc herniation’, the objective ‘lumbar discectomy’ should be replaced with a stereotyped lumbar hip and other extradural soft tissue release surgery or a combination of lumbosacral intradural (extradural) soft tissue release surgery. “[10]. From theory to practice, the theory of “intervertebral disc compression of nerve roots” was boldly criticized. The “compression theory” was attributed to disc herniation and advocated surgical removal of the disc; the “inflammation theory” was attributed to radiculitis and advocated closure and anti-inflammatory drugs. In fact, there are many traumatic injuries that can heal on their own without treatment and with rest alone. Based on this common sense, it is believed in the United States that “herniated disc compression resulting from herniated disks often responds to conservative therapy, and only certain cases require surgery. In certain cases, surgery may be needed.” Its reliance on bed rest, hospitalization, medications, and surgery constitutes the orthodox model of care in the United States, accounting for approximately 60% of the spine market; the other unorthodox model is chiropractic, which accounts for 40% of the population. Although patient satisfaction statistics are high, they are not yet reliable in terms of physical rehabilitation and economic consequences [4]. Is there a treatment that can heal the disc injury and reduce the inflammatory edema of the nerve roots, thus rapidly relieving the patient’s pain?