I. What is lumbar disc herniation Lumbar disc herniation refers to a series of symptoms and signs caused by the rupture of the fibrous ring of the intervertebral disc and the protrusion of the nucleus pulposus tissue, which compresses and stimulates the nerve roots. Lumbar disc herniation is the most common cause of lumbar leg pain and is mainly related to degeneration of the lumbar spine, overloading of the lumbar region, acute injury and other factors. The main symptoms of lumbar disc herniation are lumbago and sciatica, i.e., overcharge-like pain in the buttocks, posterior and lateral thighs, lateral calves, and dorsum of the feet, and in severe cases, dysfunction of urination and defecation. Patients often have sensory abnormalities and muscle atrophy in the lower extremities. Imaging examinations will show corresponding manifestations, such as X-ray, CT, MRI, etc. The treatment of lumbar disc herniation is divided into conservative treatment and surgical treatment. In the early stage of conservative treatment, bed rest is the main treatment, and traction, physiotherapy and sacral canal closure can also be performed. When conservative treatment is ineffective, recurrent attacks, seriously affecting the patient’s quality of life, urinary and fecal dysfunction, muscle atrophy, this is the time to undergo surgical treatment. Song Ruipeng, Department of Orthopedics, First Affiliated Hospital of Zhengzhou University Second, what is lumbar spinal stenosis Lumbar spinal stenosis is a syndrome of cauda equina and nerve root compression due to narrowing of the lumbar spinal canal, nerve root canal or intervertebral foramen. The most common cause of this disease is degenerative degeneration of the spine, but it is also associated with congenital developmental spinal stenosis and trauma. The typical symptom is intermittent claudication of neurogenic origin, i.e. pain, numbness and weakness of the lower limbs after walking for a certain distance, requiring squatting or sitting down to rest for a period of time to relieve the symptoms before continuing to walk. As the condition of the most patient worsens, the walking distance becomes shorter and the resting time becomes longer. Patients are not restricted from riding bicycles, which is a common clinical phenomenon: “I would rather ride a thousand miles than walk half a step more”. When these symptoms are present, relevant imaging tests, such as X-ray, CT or MRI, spinal canal imaging, etc., should be performed. Early patients can use conservative treatment, including rest, reduce activity, improve the circulation of drugs, physical therapy, etc., when conservative treatment is ineffective and the symptoms are serious, we need to carry out surgical treatment. Third, what is lumbar spondylolisthesis lumbar spondylolisthesis refers to the slippage of one vertebra on another vertebra, the etiology of lumbar spondylolisthesis is many, the most common is degenerative slippage. Typical cases are commonly seen over the age of 50, mostly with the lumbar 4 vertebrae slipping forward on the lumbar 5 vertebrae. As the vertebrae move forward, resulting in narrowing of the spinal canal and nerve root canal, the clinical presentation is similar to that of lumbar spinal stenosis, and a definitive diagnosis can be made by performing an X-ray, CT or MRI examination. The early treatment of lumbar spondylolisthesis is conservative treatment, and surgery is used when conservative treatment is ineffective. Fourth, what kind of condition requires lumbar spine surgery There are many types of lumbar spine diseases, and surgery should be done when the patient has the following conditions: numbness, pain, and weakness of the lower extremities that seriously affect daily work life, such as walking, sedentary, laundry, cooking, etc.; strict conservative treatment is ineffective for 3 months, with recurrent symptoms; lumbar pain with urinary and faecal dysfunction or foot drop; at the same time, there is a clear imaging with The lumbar spine slippage, lumbar spinal stenosis, disc protrusion and other manifestations associated with it, then surgery is needed. V. What are the risks of lumbar spine surgery and will it lead to paralysis? Lumbar spine surgery does have certain risks, including recurrence of symptoms, infection and nerve damage. However, this has a lot to do with the surgical technique, the experience of the operator, and the medical environment. For a spine surgeon with considerable experience, the likelihood of paralysis is very small. Sixth, the need to use imported internal fixation Why a number of lumbar spine need to use internal fixation, which needs to be combined with your condition, imaging performance and the specific circumstances of the operation to decide, it is generally believed that when there is more obvious lumbar instability will need to use internal fixation devices to achieve the purpose of restoring and rebuilding the stability of the spine, restore the height and normal physiological curvature of the intervertebral space.