(Original work, quoted by the source must be indicated, otherwise rehash must be investigated) 1. Symptoms: simple lumbar pain with / or leg pain, leg pain along the sciatic nerve distribution. The range of pain and numbness varies according to the protruding compressed nerve root segments. Guangzhou Panyu District Hospital of Traditional Chinese Medicine Interventional Department Xu Guo Zeng lumbar 5 (L5) sacral 1 (S1) nerve root compression, pain and sensory loss or numbness area as shown in the following diagram illustrates the above diagram from the Internet for reference. It should be pointed out that the pain and numbness area may cross the range indicated in the above diagram, so if you have the above typical symptoms, you can self-diagnose by comparing with the CT/MR films, otherwise, it is best to ask a specialist to assist in the diagnosis and treatment, and it can help to exclude other diseases so as to avoid delay in the diagnosis and treatment.2. Signs: It needs to be completed by a doctor, and it is positive for nerve root or cauda equina injury.3. CT images: Examples are taken from my research paper cases. Thesis case. Figure. Before intervention, transverse: herniation (double arrows) compressing the left S1 nerve root, sagittal: showing (prolapsed) non-containing L5/S1 disc herniation; coronal: showing clear herniation (arrows) compressing the left S1 nerve root. Corresponding to the area of yellow and dark green sensory loss on the left side of the S1 nerve in the upper color image.Collagenase chemonucleolysis with left translaminar approach at L5-S1 level in 32-year-old man.(a)Transverse CT image shows left L5-S1 disc herniation material (double arrow), compression of the left S1 nerve root and thickening(long arrow) compared with the contralateral nerve root at the same level. contralateral nerve root at the same level , normal right S1 nerve root (arrow), Pfirrmann grading 3. sagittal CT image shows L5-S1 disc herniation material (arrow) with the base of the L5-S1 disc herniation material (arrow). sagittal CT image shows L5-S1 disc herniation material (arrow) with the base of protrusion relatively narrower (double arrows) than the diameter of the extruding material itself ; coronal CT image shows L5-S1 disc herniation material (loog arrow),compression of the left S1 nerve root and thickening(double arrows) compared with the contralateral nerve root at the same level , normal right S1 nerve root, Pfirrmann grading 3. (b) After 6 months a reduction lumbar disc herniation material (arrow) and normal S1 nerve root were observed at the same level. normal S1 nerve root were observed at axial, sagittal and coronal CT imaging , Pfirrmann grading 0.)Figure. After intervention, the herniation was significantly reduced and no compression of the nerve root was observed.Collagenase chemonucleolysis with left translaminar approach at L5-S1 level in 32-year-old man. (a) Transverse CT image shows left L5-S1 disc herniation material ( double arrow), compression of the left S1 nerve root and thickening(long arrow) compared with the contralateral nerve root at the same level , normal right S1 nerve root (arrow), Pfirrmann grading 3. sagittal CT image shows L5-S1 disc herniation material (arrow) with the base of protrusion relatively sagittal CT image shows L5-S1 disc herniation material (arrow) with the base of protrusion relative narrower (double arrows) than the diameter of the extruding material itself ; coronal CT image shows L5-S1 disc herniation material (loog arrow), compression of the left S1 nerve root (arrow), Pfirrmann grading 3. compression of the left S1 nerve root and thickening(double arrows) compared with the contralateral nerve root at the same level , normal right S1 nerve root, Pfirrmann grafting, and the left S1 nerve root. root, Pfirrmann grading 3. (b) After 6 months a reduction lumbar disc herniation material (arrow) and normal S1 nerve root were observed at axial, sagittal and coronal CT imaging. sagittal and coronal CT imaging , Pfirrmann grading 0. Although CT/MR is widely used, better display of nerve roots in coronal position etc. has not been reported for application. It will be the future direction of application. Symptoms, signs, and consistency of CT/MR images for a clear diagnosis. Treatment selection was performed.1, Contained lumbar disc herniation, conservative treatment was preferred, ineffective intervention.2, Non-contained lumbar disc herniation, Pfirrmann grading 0-1, conservative treatment was preferred, ineffective intervention.3, Non-contained lumbar disc herniation, Pfirrmann grading 2-3, CT-guided intervention was preferred, ineffective surgical intervention.4, Non-contained lumbar disc herniation, Pfirrmann grading 2-3, CT-guided intervention was preferred. For non-contained lumbar disc herniation, Pfirrmann grading 2-3, CT-guided intervention is preferred, and surgical intervention is not effective.4,Conservative treatment is preferred for non-contained lumbar disc herniation that cannot be clearly identified.5,The following four indexes should be introduced to further subdividing the special cases: VAS, A visual analogue scale for pain; ODI, The Oswestry disability index. A-index, the ratio of the area of herniated disc material to the spinal canal. Pfirrmann grading , Pfirrmann’s Grading of lumbar nerve root Compromise. to be done by a very specialized doctor. Non-surgical treatment: About 80% of patients with lumbar disc herniation can be relieved or cured by non-surgical treatments. The goal is to accelerate the resolution of inflammatory edema in the herniated portion of the disc and the irritated nerve root, thereby reducing or relieving the irritation or compression of the nerve root (1). (1) Surgery 6th ed. 875-880. Surgical treatment: Nucleus pulposus removal may be considered in patients with diagnosed lumbar disc herniation who have failed to respond to rigorous nonsurgical treatment or who have had compression of the cauda equina. It has the potential for disc infection, vascular or nerve root injury, postoperative adhesion recurrence and other complications, and the indications for surgery should be strictly controlled (1). (1) Surgery 6th ed. 875-880. The current mess in the treatment of lumbar disc herniation is that what should be conservative is interventional and the indications are relaxed. What is even more frightening is that most surgically treated patients can be treated with interventional therapy, over-surgery. Please read the pre-diagnosis instructions carefully. If you still have questions, please upload images for your diagnosis.