Lumbar disc herniation can be divided into four stages of treatment: First stage: for mild to moderate herniation, standardized conservative treatment for 3 months, including oral medication, attention to posture and functional exercise, etc. Most of the symptoms can be relieved without surgical treatment. Second stage: If conservative treatment is not satisfactory, minimally invasive interventional therapy is recommended. Commonly used methods include nucleus pulposus ablation, radiofrequency ablation of the intervertebral disc, collagenase ablation of the intervertebral disc, and dorsal root nerve block, etc. However, the above methods are indirect decompression. However, the above methods are indirect decompression, only for some cases of accommodative herniation, and cannot completely remove the protruding intervertebral disc tissues, especially those that compress the nerves; in addition, the necrotic tissues after ablation need to be absorbed by the body naturally, which is a long time, painful and has a high recurrence rate. Third stage: If the above interventional treatments are ineffective and the symptoms gradually worsen, seriously affecting the daily work and life, surgery is required (early surgery is recommended for severe herniation, prolapse or freezing of the intervertebral disc). The goal of surgery is to remove the herniated disc and free the compressed nerve. Depending on the location and extent (size) of the herniated disc, as well as other associated problems (e.g., spinal stenosis, foraminal narrowing, etc.), the type of surgery will be determined. Minimally invasive surgery: endoscopic discectomy, microscopic discectomy with a small opening window; 2. Highly invasive surgery: laminectomy with decompression of the spinal canal, discectomy + pedicle screw fixation + implant fusion, discectomy + intervertebral fusion + implant fusion, and so on. Minimally invasive surgeries, especially endoscopic discectomy, have greater advantages in treating herniated discs, and they are the newest technology in recent years, which is safe, more effective, and less invasive. Major trauma surgery to remove the herniated disc is a direct decompression, but the surgery is traumatic, risky, expensive, and has a high recurrence rate (inflammatory irritation, bloody irritation, tissue adhesion, etc.), and some patients still cannot relieve their pain and other symptoms after the surgery, because the direct compression of the herniated disc tissues is only one of the pathogenesis of herniated discs, and some patients may even experience new symptoms (e.g., pain) that were not present before surgery. Some patients even have new symptoms that were not present before the surgery (e.g., nerve adhesion pain, postoperative pain syndrome in the low back, etc.), and they have to take oral painkillers or go to the pain department to have a nerve block for a long period of time. Fourth stage: rehabilitation. Rehabilitation is broadly defined as treatment, including functional exercises and treatment of residual symptoms such as pain, and we usually think of treatment as including rehabilitation. The goal of rehabilitation is to restore the patient’s ability to take care of himself or herself to the greatest extent possible, so that he or she can return to his or her family and work. It can be said that the appropriateness of rehabilitation therapy not only affects the efficacy of treatment, but also reduces the recurrence of lumbar disc herniation to a certain extent. Therefore, many patients with lumbar disc herniation urgently hope for a more systematic and individualized treatment plan, which can ensure the maximum efficacy of the treatment and minimize the trauma at the same time. Systematic treatment requires multidisciplinary efforts, but the treatment of lumbar disc herniation in many hospitals in China is still very simple, resulting in different treatments for patients. The complex pathogenesis of lumbar lumbar disc herniation, which is a common clinical symptom of lumbar pain and lower extremity radicular neuralgia, is still unclear. Currently, the main theories are: mechanical compression theory; chemical nerve root aseptic inflammation theory; disc autoimmunity theory. At present, the immunological research of lumbar disc herniation has made great progress by breaking through the traditional understanding. Therefore, in order to achieve the long-term efficacy of intervertebral disc: (1) the herniated disc must be returned to lift the root cause of inflammation. (ii) The edema, aseptic inflammation and adhesion of the nerve root and its causes must be relieved. (iii) Resolution of soft tissue adhesions and contractures. (iv) Minor joint disorders. “Intra-disc”, “intra-vertebral canal”, “extra-vertebral canal”, “small joint disorder”, single solution to part of the problem, which also The problem of recurrence of herniated disc is also caused. Therefore, it is necessary to solve the problem of aseptic inflammation while solving the problem of nerve root compression. However, in modern drug research, molecular biology can elucidate the etiology of many diseases, and find the target of drug therapy, the variation and defect of certain enzymes, receptors and ion channels, isolate and obtain the enzymes of bacteria or viruses, and establish the receptor model, which is the basis for the research and development of targeted drugs. In the conceptualization stage of anti-bacterial inflammation, indirect drug design lacks biological activity data due to the lack of bacterial target molecules and the lack of bioactivity data on the conformational relationship of drug molecules, and direct drug design also lacks the chemical and three-dimensional structures of bacterial target molecules due to the lack of the object of action —- and the inability to design drug molecules that can be combined with the lack of receptor modeling from the spatial shape to the chemical properties. The international pharmaceutical industry invests tens of billions of dollars each year in the research and development of new drugs, and it takes multidisciplinary and multisectoral cooperation from the screening to the marketing of a brand-new drug, with an average cost of 300-500 million dollars and a time span of 10-15 years, but no effective or potent drugs against aseptic inflammation have been found so far. Various aseptic inflammatory diseases such as cervical spondylosis, lumbar spondylosis, and frozen shoulder are afflicting the health of hundreds of millions of people, including pharmacists themselves, and the fundamental reason is that aseptic inflammation has no bacteria and thus lacks a receptor base for new drug development. What is Ozone Ozone is a strong oxidizing agent with an extremely unstable half-life of 20 minutes. After injection into the intervertebral disc, it is quickly decomposed into O2 and O-, and the residual O- can be combined with each other to form O2, therefore, it will not cause secondary contamination and long-lasting damage to the organs and tissues. The molecular weight of ozone is 48, while the molecular weight of air is 29, so after extracting ozone, it is enough to turn the syringe mouth upward. It is not easy to store and can be made on site as early as possible. In 1863, the German chemist Scobin discovered in his laboratory a mysterious gaseous substance, soluble in water, easy to decompose, with strong oxidizing ability, Scobin named this gas with three oxygen atoms as “trioxide” (Ozone). What is Medical Ozone? Medical Ozone is a mixture of pure oxygen and pure oxygen trioxide, in which the content of oxygen trioxide is between 0.05% and 5% (by volume), without its impurities. Does trioxide damage healthy tissue? The protective enzymes produced by healthy cells consist of four main enzymes: superoxide dismutase, reductase, glutathione peroxidase and catalase. As long as the cells are protected by these enzymes, ozone does not harm healthy cells. What is the principle of Triple Oxygen Therapy for Herniated Disc? Among the 3 kinds of tissue structures that constitute the cartilage endplate, annulus fibrosus and nucleus pulposus of the intervertebral disc, the content of proteoglycan in the nucleus pulposus is the highest, which reaches 40-60% of the dry weight of the nucleus pulposus, and collagen only accounts for 10-20% of the dry weight of the nucleus pulposus. In the annulus fibrosus, the collagen content is up to 50-60%; ozone can oxidize and decompose the protein and polysaccharide macromolecule polymers in the nucleus pulposus to destroy the structure of the nucleus pulposus; the volume of the nucleus pulposus shrinks and solidifies after oxidization, and the pressure of the nucleus pulposus on the nerve root disappears with the prolongation of time; and there is no damage to the annulus fibrosus and other tissues and structures. In patients with herniated discs with ruptured annulus fibrosus, the liquid nucleus pulposus overflows from the rupture opening and surrounds the adjacent nerve roots and adheres to them; the glycoproteins and β proteins of the nucleus pulposus have strong chemical irritation to the nerve roots, and the liquid nucleus pulposus releases a large amount of histamine when it comes in contact with the nerve roots, causing chemical inflammation of the nerve roots that are lacking in the bundle nerves; moreover, the polysaccharide proteins and proteins of the nucleus pulposus are of immune origin, which can cause immune inflammation after coming in contact with the nerve roots. In addition, glycoproteins and proteins of the nucleus pulposus are immunogenic and can cause immune inflammation after contact with the nerve root. After ozone injection, ozone can specifically oxidize or “burn” the structure of the medulla, astringent and solidify the liquid medulla, eliminating the chemical irritation and immunogenicity of the medulla, at the same time, due to the anti-inflammatory and analgesic effect of ozone, the patient’s nerve root pain can be immediately relieved after the injection of ozone around the nerve root. With the extension of time, the structure of the nucleus pulposus gradually atrophied and solidified, and the optimal therapeutic effect of the treatment could be achieved in 3 months. Case 1: CT-navigated triple-oxygen nucleus pulposus ablation for herniated intervertebral disc Patient, 62 years old male, lower back pain with radiating left leg pain and numbness for 12 years, had been treated with traction and massage in several hospitals, but the symptoms were repeated, and the symptoms worsened recently, so the patient came to our clinic for medical treatment. CT examination: herniated intervertebral disc of L5-S1 with calcification. 1. CT showed that L5-S1 intervertebral disc herniation was accompanied by calcification, and the herniation was to the left. 2, CT navigation puncture point localization 3, CT navigation to determine the puncture path after the L5-S1 posterior puncture 4, CT navigation shows good puncture needle site 5, CT reconstruction after the injection of trioxane showed that the nucleus pulposus was ablated at the target point After the operation, the patient’s pain symptoms disappeared, and residual numbness disappeared after 3 months. Case 2: C-arm guided L5-S1 trioxane nucleus pulposus ablation Patient, 45 years old male, main reason: “lumbosacral pain with right lower limb pain”, right L5 spinous process pressure and pain, right straight leg raising test 40 degrees, strengthening test (+), lumbar spine CT shows: L5-S1 intervertebral disc herniation, the right is more serious. After a joint discussion among the pain department, neurosurgery department, and spine surgeon, it was decided to perform L5-S1 disc triple oxygen ablation. (1) C-arm guided puncture needle arrived at the lateral position film of the intervertebral disc (2) C-arm guided puncture needle arrived at the orthopedic position film of the intervertebral disc (3) C-arm guided intravertebral disc injection with contrast agent lateral position film (4) C-arm guided intravertebral disc injection with contrast agent orthopedic position film (5) Intravertebral disc injection with trioxane in a 10 ml syringe. The patient was relieved of 90% of the symptoms at that time and discharged from the hospital and went home for recovery three days later. (Note: The above contrast images are used for research and teaching purposes.) Case 3: C-arm guided double puncture needle L4-5 nucleus pulposus ablation The patient, a 53-year-old woman, had lumbar pain with numbness and pain in both lower limbs for 2 years, and her lumbar spine CT showed L4-5 bulging discs, bilateral foraminal stenosis, and nerve root compression. After a joint discussion among the pain department, neurosurgery department and spine surgeon, it was decided to perform L4-5 nucleus pulposus ablation with double puncture needles. The patient’s back pain and lower limb symptoms disappeared after the treatment, and the numbness was reduced, and the patient was discharged from the hospital and went home to recover 5 days later. Target disc radiofrequency ablation technology Herniated disc radiofrequency (radiofrequency RF) treatment technology is a technology to treat herniated disc by precisely outputting ultra-high frequency electric wave through specific puncture guide needle, so that the local tissues can produce high temperature locally, which can play the role of thermo-coagulation or make the nucleus pulposus of the intervertebral disc to ablate and atrophy, and thus it is called as “Herniated Disc Radiofrequency Thermo-coagulation” or “Herniated Disc Radiofrequency Thermo-coagulation”. Therefore, it is also called “intervertebral disc herniation radiofrequency thermocoagulation” or “intervertebral disc herniation target point radiofrequency ablation”. The radiofrequency instrument used for pain treatment is specially set up with a nerve stimulation function, which can discover and accurately locate sensory nerves and motor nerves, and then use radiofrequency electric current to block or change the nerve conduction, so as to achieve the purpose of relieving pain. This physical nerve thermocoagulation technique can control the temperature and range of the thermocoagulation foci very well, and after treatment, it can reduce or eliminate the pain while maintaining the proprioceptive, tactile and motor functions. The main advantage of radiofrequency over other existing neurodestructive techniques is that it allows for quantitative and predictable neurothermal coagulation. Radiofrequency ablation of the intervertebral disc is mainly used for discogenic low back pain, bulging and inclusive disc herniation, but is not effective for larger herniations with prolapsed or free nucleus pulposus. Advantages: 1, the treatment process is in the C-arm guide precise positioning, in the digital subtraction detection, directly on the diseased disc, the data is accurate to less than 1mm, the whole operation can be visualized, will not hurt the surrounding normal tissues and organs and nerves, radiofrequency temperature can be controlled to ensure the safety of the treatment before and after the treatment, there is no infection, no thermal injury. 2, minimally invasive, painless. The puncture needle is only 0.7 millimeters (as thin as an infusion needle), no incision, no bleeding, no effect on the stability of the spine after the operation, little danger, and fast recovery. Rapid effect, high efficacy. The unique safety test system of RF can measure the nerves within 1cm of the treatment range; the unique impedance display function can distinguish the nucleus pulposus fibrous ring, calcification point, bone and blood vessels. It can accurately calculate the volume to be removed without hurting normal tissues, directly locate the protruding part of the target, precisely ablate the protruding material, relieve nerve root compression or irritation, quickly relieve pain symptoms, remodel the annulus fibrosus, and provide one-step treatment for lumbar disc herniation and spinal cord cervical spondylosis. Indications: 1, intervertebral disc herniation, intervertebral foraminal osteophytes caused by the spinal nerve root pain, the effect of conservative treatment is not good; 2, central, paracentral, lateral, extremely lateral type of lumbar intervertebral disc herniation; 3, part of lumbar intervertebral foraminal stenosis; 4, cervical spine intervertebral disc herniation; contraindications: 1, intervertebral disc herniation patients with serious cardiac, renal insufficiency patients; 2, Patients with laxity of the posterior longitudinal ligament, lateral ligament and instability of the lumbar vertebrae; 3. Patients with excessive osteophytes or serious calcification of the annular fibrous ligament; 4. Patients with bleeding disorders; 5. Patients who are highly skeptical of this technique and are unwilling to undergo the surgery. Advantages: 1, the operation is completed under local anesthesia, the patient is awake throughout the whole procedure, which not only avoids the risk of anesthesia, but also reduces the chance of nerve root injury; 2, the patient’s skin incision is less than 1cm, trauma is minimal; 3, the vertebral plate is not removed, the paravertebral muscles and ligaments are not destroyed, there is less interference with the nerves and the structure of the vertebral canal, the epidural fat is retained, which reduces the intra-operative bleeding and post-operative formation of the scar tissue in the vertebral canal, and lowers the incidence of postoperative instability of the vertebral body. Short operation time, quick recovery after operation, shorten hospitalization time, and reduce the economic burden of patients. Avoiding the recurrence of symptoms caused by tissue adhesion after open internal fixation; 6. Comparing with open surgery, the efficiency is comparable or even higher, and the risk and complication of reoperation for patients with poor results of open surgery are significantly higher; 7. The cost of surgery is 1/3-1/6 of that of open major surgery, which reduces the economic burden of patients.