Lumbar Herniated Disc Pain Causes and Treatment Options

Lumbar disc herniation: a common clinical condition and the most frequent cause of low back pain. Epidemiologic analyses at home and abroad show an increasing trend in population rates and absolute values of its incidence. The age of onset ranges from a few years to tens of years. The rise in incidence is related to changes in the environment we live in and our living and working habits. One of the main causes of morbidity is long-term poor lumbar habits. Lumbar disc herniation is mainly due to the lumbar intervertebral disc parts (nucleus pulposus, annulus fibrosus and cartilage plate), especially the nucleus pulposus, there are varying degrees of degenerative changes in the role of external factors, the intervertebral disc of the annulus fibrosus rupture, the nucleus pulposus tissue protrudes from the rupture place (or out) mostly in the posterior or in the vertebral canal, leading to the adjacent spinal nerve roots suffered from irritation or compression, resulting in pain in the lumbar region, a side of the lower limbs or double lower limbs Conventry has reported mild degenerative changes in the intervertebral discs of young adults in their late 20’s, with relatively significant degenerative changes occurring between the ages of 20-30 years, with some of the annulus fibrosus appearing to be fissured. This rate is even higher in the older age groups. Roberts did a study of nearly 100 cadaveric lumbar specimens, and all of the middle-aged specimens had degenerative discs. In specimens younger than 30 years of age, the discs were partially degenerated and to a relatively lesser degree. This shows that physiologic degeneration of lumbar intervertebral discs is an age-related biological process. With the development of imaging, CT and MRI have gradually become reliable means of diagnosing lumbar disc herniation, which can accurately show the location and direction of the herniated disc and the nerve root compression, providing good conditions for surgical treatment of lumbar disc herniation. No matter which surgical methods are used, they are all aimed at treating herniated discs, and the criteria for judging the effect are: whether the pain is cured or not, whether the sequelae are obvious or not, and whether it is easy to recur or not. Orthopedic traditional posterior full or half laminectomy to remove the nucleus pulposus of the intervertebral disc surgery on the lumbar spine of the integrity of the three columns of the structure of the lumbar vertebrae have different degrees of damage, the stability of the lumbar vertebrae have a certain impact, the need to be fixed with a steel plate screws, the majority of patients with pain is difficult to understand and accept. Minimally invasive treatment of lumbar disc herniation in pain medicine solves this problem. Its history can be traced back to the invention of chemical fusion nucleus pulposus in 1963. Its history can be traced back to the invention of chemical fusion nucleus pulposus in 1963.In 1963, Smith pioneered minimally invasive spinal surgical treatment techniques by first utilizing percutaneous disc puncture and injecting papaya gel protease into the epidural space to treat lumbar disc herniation. The basic principle of the technology is to use the hydrolysis of protease, the nucleus pulposus tissue collagen partially dissolved, water release, and ultimately atrophy, resulting in a reduction in intravertebral disc pressure, thus lifting the nerve root compression, due to the fact that so far no one has solved the papaya enzyme allergy has been replaced by the current use of non-allergenic collagen protease. Collagenase can dissolve the collagen tissue in the protruding nucleus pulposus and annulus fibrosus without damaging other normal tissues in the neighboring structures, and the postoperative pain level scores are comparable to the effects of surgical treatment. Percutaneous puncture ozonolysis is a treatment method that has been applied in European countries in recent years. It is believed that ozone oxidizes proteoglycans in the nucleus pulposus, destroys the nucleus pulposus cells, suppresses the immune response, and has an anti-inflammatory and analgesic effect.Bonetti et al. believe that injecting a mixture of O2 and 03 gases around the nerve root can also relieve pain. Intravertebral disc ozone injection is a more effective and safer method of treating lumbar disc herniation, with a total effective rate of 93.2%. Radiofrequency ablation myeloplasty system: Using the low temperature (about 40℃) vaporization technology of cold ablation cutting, part of the nucleus pulposus tissue is removed, and the collagen fibers in the nucleus pulposus are vaporized, contracted and assimilated using the heating (70℃) technology, so that the total volume of the intervertebral disc is reduced, which leads to the lowering of intravertebral disc pressure and remodeling of the nucleus pulposus tissue of the intervertebral disc to achieve the therapeutic purpose. It has been reported that under percutaneous endoscopic guidance, the application of bipolar electrode radiofrequency ablation technology was applied to 40 patients with lumbar disc herniation, and the total effective rate was 86.4%. Combined application of ozone or collagenase is the trend of minimally invasive comprehensive utilization in recent years, and in 2007, Kou Joushe reported that under the guidance of CT and C-arm, the treatment target was determined according to CT and MRI, and the excellent rate of treatment reached 80%, and the effective rate reached 96%. Intervertebral foramenoscopy for the treatment of herniated disc pain is suitable for herniated material that is large and accompanied by herniated material that is free in other directions. This technique is better at relieving the pressure of the herniation on the nerves at one time, and once the herniation is removed, the patient’s severe pain symptoms are randomly relieved.