Treatment 1, non-surgical treatment Most patients with lumbar disc herniation can be relieved or cured by non-surgical treatment. The treatment principle is not to return the degenerated and herniated disc tissue to its original position, but to change the relative position of the disc tissue and the compressed nerve root or to partially retract it, so as to reduce the pressure on the nerve root, release the adhesion of the nerve root and eliminate the inflammation of the nerve root, thus relieving the symptoms. Non-surgical treatment is mainly suitable for: (1) young people, first attack or short duration of disease; (2) people with mild symptoms, whose symptoms can be relieved by themselves after rest; (3) people with no obvious spinal stenosis on imaging. (1) Absolute bed rest For the first attack, bed rest should be strictly applied, emphasizing that neither bowel movements nor urination should be performed by getting out of bed or sitting up, so as to have better results. After 3 weeks of bed rest, you can get up and move under the protection of wearing a lumbar girth, and do not bend over and hold things for 3 months. This method is simple and effective, but more difficult to adhere to. After remission, the lumbar back muscle exercise should be strengthened to reduce the chance of recurrence. (2) Traction therapy The use of pelvic traction can increase the width of the vertebral space, reduce the internal pressure of the intervertebral disc, the herniated part of the disc retracts, and reduce the irritation and compression of the nerve root, which needs to be carried out under the guidance of a professional doctor. (3) Physiotherapy, massage and tui-na can relieve muscle spasm and reduce the pressure within the intervertebral disc, but note that violent massage and tui-na can lead to aggravation of the disease and should be done with caution. (4) Corticosteroid epidural injection Corticosteroid is a long-acting anti-inflammatory agent, which can reduce inflammation and adhesions around the nerve root. Generally, long-acting corticosteroid preparation + 2% lidocaine is used for epidural injection once a week for 3 times as a course of treatment, and another course can be used after 2-4 weeks. (5) Medullary nucleus chemical lysis method Using collagenase or papain, injected into the intervertebral disc or between the dura mater and the herniated nucleus pulposus, selectively dissolve the nucleus pulposus and fibrous ring without damaging the nerve roots to reduce the pressure in the disc or make the herniated nucleus pulposus smaller so as to relieve the symptoms. However, there is a risk of allergic reaction to this method. 2.Percutaneous myelotomy/myeloplasty The nucleus pulposus will be suctioned out or laser vaporized by entering the intervertebral space under X-ray surveillance with special instruments, so as to reduce the pressure in the intervertebral disc and achieve symptomatic relief. 3.Surgical treatment (1)Indications for surgery ① history of more than three months, strict conservative treatment is ineffective or conservative treatment is effective, but frequent recurrence and heavy pain; ② first attack, but the pain is severe, especially in the lower extremities, the patient is difficult to move and sleep, in a forced position; ③ combined with the expression of the cauda equina nerve compression; ④ single nerve root paralysis, accompanied by muscle atrophy, muscle strength loss; ⑤ combined with the spinal canal stenosis. (2) Surgical method Through a posterior lumbar back incision, partial laminectomy and synovectomy, or laminectomy through the intervertebral space. For central disc herniation, after laminectomy, epidural or intradural discectomy is performed. In cases of combined lumbar instability and lumbar spinal stenosis, simultaneous spinal fusion is required. In recent years, minimally invasive surgical techniques such as microdiscectomy, microendoscopic discectomy, and percutaneous foraminoscopic discectomy have reduced surgical damage and achieved good results. 4, prevention: lumbar disc herniation is caused by accumulation of injuries on the basis of degeneration, accumulation of injuries will aggravate the degeneration of the intervertebral disc, so the focus of prevention is to reduce the accumulation of injuries. Usually have a good sitting posture, the bed should not be too soft when sleeping. Long-term ambulatory workers need to pay attention to the height of the table, chair, and regularly change the posture. Occupational work requires frequent bending movements, should regularly stretch, chest activities, and use a wide belt. Should strengthen the lumbar back muscle training to increase the intrinsic stability of the spine, long-term use of waist circumference, especially need to pay attention to lumbar back muscle exercise to prevent the adverse consequences of disuse muscle atrophy. If you need to bend over to get something, it is best to use hip flexion, knee flexion squatting way to reduce the pressure on the back of the lumbar intervertebral disc.