The patient: the initial disease in 1999, by a coal mine sanatorium traction treatment, the condition reduced but the left thigh and February 2009 work aggravated, the left sciatic nerve, thigh, calf pain pain unbearable two bunions toe pain, by massage and rest pain relief. early May appeared saddle area discomfort, sore and tired. Now (August 3, 2009) the left sciatic nerve, the back of the outer thigh, the outer calf, the left toe has pain numbness on the outside of the palm of the foot, the left leg can not bear weight, especially the left toe pain is obvious and sometimes there is needle pain (the right sciatic nerve sometimes has pain); two inner thigh root pressure has pain, scrotum pressure has not obvious pain, feel thick skin and scrotum cold; penis occasionally has needle pain, root The discomfort is obvious, and the pain in the pubic area is clearer when I bend over to wash my face. The above symptoms worsen after a day of sitting or activity. I would like to ask Dr. Ren to diagnose my condition. Which is suitable for my symptoms, posterior intervertebral surgery or open surgery? Are there any postoperative complications? How much will it cost to receive treatment at your hospital? How many days will I need to be hospitalized? CT examination on April 24, 2009: the physiological curvature of the lumbar vertebrae was acceptable, the sequence was regular, the vertebrae did not show osteophytes, the lumbar 4/5 intervertebral disc protruded backward, the dural naan was obviously compressed, and the ligamentum flavum was not thickened. MR imaging on July 14, 2009 showed normal lumbar spine sequence with straightening of curvature and varying degrees of osteophytes. the L4/5 and L5/S1 intervertebral spaces were narrowed, the intervertebral disc protruded backward, the dural sac was compressed, and the effective sagittal diameter of the spinal canal was 0.7 cm and 1.2 cm, respectively. the T2 signal of the intervertebral disc was reduced. There was no obvious abnormal signal in the spinal canal and surrounding soft tissues. Ren Shou Song, Department of Spine Surgery, Jimo City People’s Hospital: The vast majority of patients suitable for open surgery are suitable for discoscopic surgery. In the past 5 years, except for the second half of 2007, when discoscopic surgery was stopped because of the failure of key parts of discoscopic equipment and open surgery was performed instead, all other discectomies were performed with the aid of discoscopic surgery. Discoscopic surgery is less invasive and has a faster recovery than traditional open surgery, resulting in a shorter hospital stay and a much smaller total treatment cost than traditional surgery. Most of our patients undergoing such surgery cost less than 5,000 RMB. (The average cost of similar open surgery in Qingdao is about 10,000 RMB). The total hospital stay is about one week. You can get out of bed the day after surgery (traditional open surgery requires 3-4 weeks of bed rest). Currently, patients come from all over the province (as far as Cao County, Lijin, etc.) and Qingdao city and other counties, which is the department with more foreign patients. Patient: Director Ren: Hello! I am delaying your precious rest time. I have a fear of open surgery, and I am afraid that there will be no other treatment measures if it fails. But I am worried that posterior disc surgery will not clean up the lesion or the treatment will not be comprehensive if the visualization range is small, and the disease will recur, so it is difficult to decide. I would like to ask you to solve the problem. Ren Shou Song, Spine Surgery Department, People’s Hospital of Jimo: The only difference between discoscopic surgery and traditional open surgery is the size of the surgical incision, whether or not the muscle is stripped, whether or not there is image magnification, and whether or not there is cold light source illumination, other than that, the surgical goal is exactly the same. Doctors who say that the surgical field of view is small or that the lesion is not completely removed do not really understand discoscopy. Open surgery is a relatively low-technology procedure, and microscopic surgery is a high-technology procedure. A surgeon who is skilled in discoscopic surgery is bound to be able to easily navigate open surgery, and vice versa is absolutely impossible. Some spine surgeons can also make an open incision of about 3 cm and use this as a reason not to use a discoscope, but this is not true. The consequences. The discoscope is unique in that it uses a dilating cannula to reach the surgical site and finally completes the procedure within the working cannula, and when the cannula is removed at the end of the procedure, the dilated muscles and soft tissues retract, completely filling and filling the cavity left by the procedure. No dead space is left at the surgical site, so additional holes are rarely poked outside the incision to place drains. The surgical field is magnified 60 times on the monitor under clear illumination and small bleeding spots during the operation are stopped with a bipolar electrocoagulator to facilitate clear visibility of the surgical field, resulting in minimal bleeding during the operation, usually within 30 ml, which is not possible with conventional surgery. Another benefit of microscopic surgery is that the space between the nerve root and the disc is more clearly distinguishable during surgery, and in many cases the disc tissue can be removed without pulling the nerve root, whereas with conventional vision it is not possible to remove the disc at all without pulling the nerve root. Twenty years ago, the knee joint was basically cleaned by open surgery, and the incision in the front of the knee joint could be 15-20 cm, and the lesions of cartilage and synovial tissue were not clear to the naked eye, so the surgery was not only traumatic, but the lesions were not clearly distinguished. It would be intolerable for a professional joint surgeon to perform this surgery on a patient. Most knee surgeries can now be done arthroscopically, which, in addition to being minimally invasive and having tiny incisions, provides a much better understanding of knee lesions. Unfortunately, however, this is not the case when it comes to discoscopic techniques. The reason for this is that discoscopic techniques have a very high technical platform that even most highly skilled and specialized spine surgeons are unable to perform, so there is a wide variety of claims. This is something that we hope patients will understand.