Lumbar disc herniation, referred to as lumbar synostosis, is a common and frequent disease in orthopedics, and is one of the most common causes of back and leg pain, which mostly occurs in young and middle-aged people, with greater pain, more troublesome treatment, and easily recurring, seriously affecting people’s quality of life and ability to work and labor. Questions are answered as follows: 1, how does lumbar synostosis get sick? As the intervertebral disc tissue bears the weight of the body, the strain is heavier than other tissues, and as age increases, degeneration is very likely to occur, and lumbar disc degeneration is the basic cause of lumbar herniation, which is a clear cause. Other factors are trauma, especially the onset of adolescence, which is closely related, although some scholars believe that trauma is a causative factor of lumbar synostosis; there are also occupational relationships, pregnancy, genetic factors, etc., which can easily lead to the onset of lumbar synostosis. 2.What are the main symptoms of lumbar synostosis? Most patients with lumbar synostosis have lumbar pain and sciatica because 95% of lumbar synostosis occurs in the L4/5 and L5/S1 intervertebral discs. In order to alleviate the symptoms, patients tend to adopt the bending, hip flexion, and knee flexion positions. They are afraid to bend when the back pain is severe. The performance of each patient is not consistent, some have only low back pain or leg pain, some have low back pain with unilateral sciatica, and only a few have low back pain with bilateral sciatica. Numbness and muscle atrophy: also a common symptom in patients with lumbar synostosis, which is more difficult to recover from clinical treatment; intermittent claudication: patients walk a short distance of only ten meters or so, mostly hundreds of meters, and the symptoms can be relieved by resting for a period of time, and then the symptoms reappear when walking again. Others have cauda equina syndrome, which appears in the central type of lumbar synostosis, which is a more urgent clinical symptom that can appear abnormalities in urination and defecation, and once it occurs, immediate surgical treatment is required to not delay the condition. When you bend over to retrieve something or squat toilets with force causing lumbago involving leg pain and lifting your legs with obvious pull-like radiating pain, you may have lumbar synostosis and should immediately go to the hospital to see an orthopedic surgeon for consultation or advice. After the doctor understands the situation and considers the disease, he or she will usually suggest you to take lumbar spine X-rays, do lumbar spine CT, magnetic resonance examination, in order to make an early diagnosis and prevent the condition from worsening. 3.What should I do if I have lumbar synostosis? There are many treatment options for lumbar synostosis, and it is best to treat it under the guidance of a physician and decide on a treatment plan based on the patient’s signs and symptoms and the results of ancillary tests. There are usually three types of treatment: ① Conservative treatment: rest on a hard bed and exercise the lumbar back muscles. Relieving the pressure on the intervertebral disc is a prerequisite for achieving therapeutic effect. Other methods include Chinese and Western medicines, massage, physiotherapy, traction, acupuncture, small acupuncture, intravertebral injection, etc., which have the effect of eliminating local inflammation, increasing local blood supply and relieving muscle spasm. ②Interventional treatment: Compared with traditional surgical methods, minimally invasive interventional techniques have the advantages of less trauma, faster recovery, no damage to the normal structure of the spinal canal and no impact on the biomechanical stability of the spine. For example, ozone ablation, collagenase chemolysis, percutaneous laser disc decompression, plasma nucleus pulposus cryoablation, etc. Surgical treatment: 5-10% of patients with disc herniation require surgery after non-surgical treatment is ineffective. In case of cauda equina injury or nerve root paralysis, emergency surgery should be performed to release the nerve compression as soon as possible. But surgery is often more dangerous, more traumatic, affects the stability of the spine and slow recovery after surgery. 4. Must lumbar synostosis be treated surgically? Many patients with lumbar synostosis are advised to undergo surgery after conservative treatment such as traction and massage is ineffective, but in fact, at least 90% of patients with lumbar synostosis do not need surgery. Surgery is only necessary when conservative treatment is ineffective and the patient’s pain is unresolved and seriously affects work and life. The specific methods include minimally invasive treatment and open surgical treatment, the choice of which is determined by the doctor according to the patient’s specific situation. Our specialty uses characteristic treatment techniques that can quickly relieve symptoms of lumbago, sciatica, leg and foot numbness caused by lumbar synostosis and significantly improve the quality of life, and some patients’ symptoms disappear completely. Patients treated by our department are those who have been treated in major hospitals in Shanghai by general treatment with poor results or recommended to have surgery, and no cases of surgery are found to be necessary after treatment, and this issue is a serious one. Patients can go to the orthopedic department of the hospital for a detailed examination to get the disease checked out is necessary, but the treatment aspect in western hospitals may be more simple and there is no good solution except drugs or surgery. Our experience in the treatment of lumbar synostosis in our specialty is to insist on a comprehensive treatment method combining Chinese and Western medicine, which has a great advantage over a single treatment method. This is also the higher level of conservative treatment for lumbar synostosis in China at present, which can save a lot of medical resources. 5.How to prevent lumbar synostosis? For lumbar synostosis, 80%-90% of patients can obtain satisfactory results and good prognosis after regular and systematic non-surgical treatment, but this does not mean that they can rest easy from now on, they still need to strengthen the functional exercise of lumbar back muscles. During bed rest, you can choose “five-point” (i.e. lying on your back with your abdomen and buttocks raised upwards, relying on the head, elbows and feet to support your body) “three-point” (i.e. lying on your back with your abdomen and buttocks raised upwards, relying on your head and feet to support your body) “three-point” (i.e. lying on your back with your abdomen and buttocks raised upwards, relying on the head and feet to support your body) (i.e., lying on the bed with arms on both sides of the body and legs straight, then lift the head, upper limbs and lower limbs upward with force like a swallow) and other exercises. The first 3 months after getting out of bed should be protected by waist circumference, after which you can exercise in the form of Taijiquan, Ba Duan Jin, Yi Jin Jing, etc. Young adults can do pull-up exercises in the form of bar suspension to enhance the lumbar back muscles and spinal stability. The usual life care is as follows: 1, pay attention to diet and nutrition. Such as dairy products, soy products, egg custard, a variety of soups, eat more fresh vegetables and fruits. Pay attention to dietary taboos, cold, spicy and stimulating food, it is best not to eat or eat less; 2, pay attention to warmth, to prevent the waist and legs from getting cold, cold can aggravate the pain symptoms; 3, pay attention to rest, to prevent overwork, work too long; 4, stand and sit in the correct posture, the same posture do not keep too long, often move around; 5, pay attention to the degree of bending, do not too fast and too hard, try not to lift heavy objects, to prevent sprained waist; 6. Adhere to regular exercise, you can practice backward walking and other movements, so that the center of gravity of the intervertebral disc backward.