Is it really necessary to open an operation for lumbar disc herniation?

Lumbar disc herniation is a common cause of low back and leg pain in adults over 20 years of age. Its main characteristic is that leg pain is worse than lumbar pain, which is aggravated by activities and can be temporarily relieved by bed rest, but in severe cases it can cause walking difficulties and affect daily life. This kind of lumbar disc herniation with painful symptoms is called lumbar herniation, and for asymptomatic herniation, treatment is generally not required. The diagnosis of lumbar herniation is easy, as it can be clearly diagnosed by having symptoms of lumbar legs, combined with CT or MRI examination to confirm the presence of lumbar disc herniation in the corresponding segment and side, and excluding tumor, tuberculosis and arterial occlusive vasculitis. For the treatment of lumbar herniation, most patients first think of going to orthopedics for open surgery. It is true that orthopedic surgery to remove the herniated discs allows for effective treatment of lumbar herniation. However, since the introduction of minimally invasive interventions in pain medicine, 90% of lumbar herniations do not require surgery. Just as people are divided into three, six, and nine classes, lumbar herniation is also divided into three classes: mild, moderate, and severe. For mild herniation of the lumbar disc, no surgery is needed at all, just rest in bed for a few days and the symptoms will be relieved naturally; for moderate herniation with symptoms of back and leg pain, orthopedic surgery can be chosen, or minimally invasive interventional therapy of the pain department can be chosen, through the injection of anti-inflammatory and analgesic drugs into the built-in tube of the intervertebral spine or radiofrequency ablation at the target point of fine needle puncture, which can make moderate herniation become mild and thus avoid open surgery. For severe herniation of the lumbar disc, which constitutes severe compression of the corresponding nerve roots, patients often have weakness and numbness of the lower limbs in addition to severe pain in the lower limbs and difficulty in walking, and even have difficulty in passing stools and urine. In the past, these were absolute indications that required orthopedic open surgery. However, with the progress of medical technology, minimally invasive treatment has become the mainstream, and surgery that would require a major incision is now unnecessary. For example, the original open ureteral stones, the waist to open 15 centimeters of the mouth, but now ureteroscopy can be broken under the stone; the original cut gallbladder to open 6, 7 centimeters of the mouth, but now the laparoscope as long as a small hole can be. The same goes for lumbar synostosis, a serious protrusion, and no more open surgery! Jiaxing First Hospital pain department introduced intervertebral foramoscopy technology, as long as the patient’s waist with a fine needle puncture to the protrusion, and then expand the needle hole to about half a centimeter, insert the intervertebral foramoscope, under the mirror can be removed in steps, so that serious herniated disc can be cured without open surgery, Jiaxing First Hospital has carried out intervertebral foramoscopic treatment of lumbar disc herniation dozens of cases, well received by patients.