I remember that one morning last year, just after winter, a 60-year-old grandfather came to my consultation room and sat down on a chair, “Doctor, I am very prominent in all aspects, but the most prominent thing that is engraved in my heart is the lumbar disc protrusion, because the pain really kills me, and this time to count nine my days are even more difficult! The moncler jackets for sale are a great way to get the most out of your life. The “lumbar disc protrusion” in the moncler outlet store mouth is strictly known in medicine: “lumbar disc herniation”, which is a spinal surgery “famous” disease. Although everyone is familiar with it, but the understanding is not deep enough there are many misconceptions, many friends talk about “sudden” fear, full of anxiety and fear. Today and friends together with the “analysis” of this familiar and unfamiliar disease, so that we can understand the causes and consequences of this disease, and only after that will be comfortable to face. First of all, we must increase confidence: “lumbar disc herniation” is definitely not a beast, in the current medical technology, it is preventable and treatable, through the joint efforts of doctors and patients can be completely conquered. “Doctor, I’ve been having back pain lately, am I suffering from a herniated disc?” These are the words I hear most often when I go to the clinic. In fact, simple lumbar pain or leg pain does not necessarily mean lumbar disc herniation. The typical manifestation of lumbar disc herniation is lumbar pain accompanied by radioactive string pain like electricity in the lower limbs, numbness and weakness, muscle atrophy (the thickness of the two legs are different), and in severe cases, weakness in urination and defecation, incontinence, etc. If combined with lumbar spinal stenosis, intermittent claudication may also occur: numbness and pain in the lower limbs may occur after walking more, and the symptoms may be relieved after squatting or sitting for a while, and then the same symptoms may occur after walking for a distance. This is a symptom caused by the nucleus pulposus of the lumbar disc breaking through the fibrous ring to compress or stimulate the nerve roots, spinal cord, and cauda equina nerve for various reasons. Once similar symptoms occur, it is necessary to seek medical attention and perform imaging tests to determine if the disc is a lumbar disc herniation. It should be noted that if a lumbar disc herniation is seen on the imaging examination without these typical symptoms, which means that the nerve is not stimulated and compressed, then we can only call it “lumbar disc herniation” instead of “lumbar disc herniation”. There is no need to blindly panic as soon as you see the words “lumbar disc herniation” in the examination report. “Doctor, you said I am not a lumbar disc herniation, so what other diseases could it be?” This is also the question of many patients. If it is simply lumbago, the most common is lumbar muscle strain or lumbar myofasciitis, mostly seen in young and middle-aged people, who work in one posture for a long time and lack of exercise, and over time will develop chronic strain on the muscles and ligaments of the lumbar back and produce pain. Injury or cold and heavy physical labor may also appear lumbar pain, spinal tumors can also appear lumbar pain but is less common, caused by spinal fractures of lumbar pain more often have a history of trauma. If the pain is simply in the buttocks or lower extremities, the most common is pear-shaped muscle syndrome or radiculitis. Pear-shaped muscle syndrome is the pain caused by the sciatic nerve being stuck in the pear-shaped muscle in the buttocks, and simple leg pain should also exclude arterial stenosis or occlusion in the lower extremities. When the patient has low back pain, along with significant lower limb radiating pain, numbness, weakness, and even abnormal urination and defecation, and numbness around the perineum, it is time to go to orthopedics or spine surgery. The doctor will choose CT or MRI of the lumbar spine according to the patient’s condition. Combined with the patient’s medical history, if the signs and symptoms and the site of nerve compression by a herniated disc in the imaging correspond to each other, the diagnosis of lumbar disc herniation will be confirmed. Many patients often feel very anxious and helpless when they learn that they have a herniated disc, but this is not necessary because it is a common disease of the spine that can be cured. Depending on the severity of the disease, a variety of treatment options such as conservative treatment and surgery can be chosen, and satisfactory results can be obtained by choosing the right treatment option. If the symptoms are mild and the course of the disease is short, and the herniated disc is not severe, non-surgical treatment is preferred and most patients have satisfactory results. Non-surgical treatment includes: bed rest, usually 3-4 weeks in a slightly rigid bed, and strict wearing of a lumbar brace when moving to the floor. When the pain is obvious, non-steroidal anti-inflammatory and neurotrophic drugs can be used to relieve the symptoms. In addition, you can go to a regular hospital for rehabilitation physiotherapy, but rough massage traction often aggravates the symptoms and should be avoided as much as possible. It is recommended that friends who work in a sedentary position for a long time should increase aerobic exercise and functional exercises for the lumbar back muscles, such as the “little swallow fly” and “five-point support”, to enhance the strength of the muscles of the lumbar back and reduce the local pressure on the intervertebral discs. Because the pressure on the lumbar intervertebral disc is about 3-4 times the weight when sitting and standing forward, over time it is easy to cause fibrosis tearing and nucleus pulposus prolapse to produce symptoms, so try to avoid continuous sitting and standing work, which not only helps the disease recovery, but also can effectively prevent the onset. If the above treatment is not effective, the following cases should be considered for surgery. Firstly, the symptoms of low back pain are serious and recurrent, and the effect of strict and regular conservative treatment is not good, and the symptoms gradually worsen, seriously interfering with daily life and work. Secondly, the nerves are obviously involved and there is a decrease in muscle strength and foot drop (inability to lift the feet and hook the toes). Uncontrollable urination and defecation and incontinence appear, which are manifestations of cauda equina syndrome and indications for emergency surgery. When it comes to surgery, patients often have concerns and are always worried about the risks associated with surgery. In fact, the safety margin of surgery is very high. The surgeon and anesthesiologist will conduct a comprehensive assessment of the patient’s overall condition, and the safety of the surgery is guaranteed after the assessment. Current surgical techniques are very mature, and there are a variety of surgical approaches, including both traditional open surgery and the current rapid development of minimally invasive spine surgery. The principles of the different surgical options are basically the same, i.e., removal of the compressing nerve (decompression), with the option of fixation and fusion as needed. “Doctor, will I be paralyzed after surgery?” This question is asked in almost all pre-operative conversations with patients. I will tell the patient that the risk of paralysis from surgery is very low, even much lower than the risk of paralysis from allowing the nerve to remain compressed without surgery, which means that it is only easy to become paralyzed without surgery. The purpose of surgery is to relieve pressure, relieve pain and prevent paralysis as soon as possible. Once the best time for surgery is missed, it may cause permanent irreversible sequelae, such as claudication, difficulty walking, incontinence, sexual dysfunction, etc., which may not be recovered by surgery afterwards! In fact, surgery is not as terrible as people think, even the traditional general anesthesia open surgery, the so-called open surgery, in the second day after surgery can be taken out of bed with a waist brace, the wound intradermal suture does not need to remove stitches, 3 days after surgery can be discharged from the hospital, the basic life after surgery can take care of themselves. In addition to open surgery, there is also minimally invasive spine technology, which is a new concept of surgery, and there are a variety of surgical methods, the most minimally invasive of which is currently recognized as “intervertebral foraminoscopy”. This technique is highlighted below. Intervertebral foraminoscopy is a spinal endoscope, the same principle as the familiar laparoscope and arthroscope. It is a tube and lens equipped with a light source, and after precise positioning, a small 0.8 cm incision is made on the side or back of the body to reach the lumbar disc herniation site. The doctor carefully protects the nerve and then carefully removes all the tissue that is compressing the nerve with a grasper, and the symptoms are relieved immediately after the nerve is completely freed. Most of the patients are under local anesthesia, and the surgery is completed while the surgeon and the patient are talking on the operating table. The purpose of the conversation is to determine whether the patient has any discomfort in the lower extremities, so that the nerve can be effectively prevented from being damaged during the surgery. After the surgery, the patient is surprised to find that the previous symptoms are gone and he or she can get out of bed immediately. It is important to emphasize that there is no superiority between open spine surgery and minimally invasive surgery for lumbar disc herniation, as the doctor will choose the right technique for the patient based on the condition. Minimally invasive surgery is of course safer, less invasive, and faster to recover than open surgery.