Lumbar disc herniation

The intervertebral disc is located between two adjacent vertebral bodies and has two parts: the outer part is the fibrous ring, which is composed of multiple layers of fibrocartilage rings arranged in a circular pattern, surrounding the nucleus pulposus, preventing the nucleus pulposus from protruding outward, and the inner part is the nucleus pulposus, which is an elastic gelatinous substance that has the effect of moderating the impact. In adults, the intervertebral disc undergoes degenerative changes, the fibers in the annulus fibrosus become thicker, glass degeneration occurs and finally rupture, so that the disc loses its original elasticity and cannot bear the original pressure. Under excessive strain, sudden change of position, violent action or violent impact, the annulus fibrosus can expand outward, so that the nucleus pulposus can also protrude outward through the fissure of the ruptured annulus fibrosus, which is called disc herniation. The main clinical manifestations are: low back pain and radiating pain of one lower limb are the main symptoms of the disease. Low back pain often occurs before leg pain, or both may occur simultaneously; most have a history of trauma, or may have no clear cause. The pain has the following characteristics: the radiating pain is transmitted along the sciatic nerve and goes straight to the lateral calf, dorsum of the foot or toes. It may also produce radiating pain to the front of the thigh. Coughing, sneezing and defecation can aggravate the back pain and radiating pain. The pain increases with activity and decreases with rest. Bed position: Most patients lie in the lateral position and flex the affected limb; individual severe cases have pain in all positions and can only bend the hip and knee in bed to relieve symptoms. In combination with lumbar spinal stenosis, there is often intermittent claudication. Scoliosis deformity: the main bend in the lower back, more obvious when forward flexion. The forward flexion and backward extension of the spine is limited, and radiating pain to one lower limb may occur during forward flexion or backward extension. There may be pressure pain in the lumbar region with radiating pain. There may be hyperalgesia of the lower extremity. If the nerve compression symptoms are severe, there may be muscle atrophy in the affected limb. If the prominence is large, the numbness area on the affected side is often more extensive and may include the buttocks, lateral femur, calf and foot. There may also be loss of control of urination, wet pants bedwetting, constipation, sexual dysfunction, and even partial or major paralysis of both lower limbs. The treatment of lumbar intervertebral disc mainly has the following methods: 1, general treatment Resting on a hard bed is one of the most basic treatment means in the acute stage. 2.Medication Non-steroidal anti-inflammatory drugs, steroids, dehydrating agents, drugs to improve circulation 3.Pelvic traction 4.Nerve block plus massage 5.Minimally invasive interventional treatment Interventional treatment of discogenic pain has developed rapidly in recent years, including percutaneous discotomy, chemical nucleus pulposis, radiofrequency ablation and discoscopic direct vision surgery, etc. These methods are still under continuous development, and their The exact indications and contraindications are yet to be established, and the specific operation specifications are being summarized and generalized. 6.Surgical treatment When the non-surgical treatment fails to cure, long duration of the disease, recurrent attacks, protruding nucleus pulposus adhesions, calcification, combined with spinal stenosis and other conditions, affecting normal life and labor, surgical treatment should be performed.