I. Etiology Lumbar disc herniation is a common cause of low back pain. When a simple disc herniation is asymptomatic, it does not require treatment, and only when symptoms arise do you go to the hospital for treatment. The main cause of disc herniation is due to degenerative changes in the intervertebral disc, referred to as degeneration (i.e. aging), people begin to age at about 30 years of age, only the aging is smaller, and accelerated after the age of 60. The most common manifestation is osteophytes, do not think that this is a disease of old age, in fact, from the age of 30, just not obvious, the same simple osteophytes is not a disease, no need to treat. Only when this hyperplasia compresses the nerves and produces symptoms does treatment become necessary, which is actually very rare. The various causes of lumbar disc herniation can be understood in detail through the internet and I won’t go into detail here. The main manifestation of lumbar disc herniation is lumbar pain and lower limb pain, but it is sometimes difficult to diagnose because there are so many manifestations, such as simple lumbar pain and simple leg pain; it can be lumbar and leg pain at the same time; this pain can be soreness, stabbing pain, burning pain; sometimes it manifests as chills and fever in the lower limbs, etc. This is why sometimes outpatient clinics take pictures, do CT, and do MRI. In the clinic, patients often say, “Doctor, do a test to confirm the diagnosis right away”. Sometimes patients say, “I can’t confirm the diagnosis after so many tests, but the doctor knows how to do more tests”, which is indeed a bit wrong to the doctor. The diagnosis of lumbar disc herniation cannot be made 100% by the above mentioned tests, because sometimes some other diseases can show the same symptoms as lumbar disc herniation, which can lead to misidentification if you are not careful, such as spinal stenosis, tumor in the lumbar spinal canal, neurological disorders and so on. This is the reason why sometimes the diagnosis of lumbar disc herniation becomes other diseases after a few days or a period of time, and patients often think it is a misdiagnosis, and medical disputes arise. At present, our hospital outpatient clinics are not fully booked, because there are often too many patients, and the doctor has not formed the habit of explaining in detail, so there are many misunderstandings and disputes, for which I hope patients can understand when they visit the doctor, and I also hope that we do doctors can explain to patients in detail, so as to improve the current abnormal doctor-patient relationship. (a) Most lumbar disc herniation can be cured by non-surgical treatment, only a very small number of people finally need surgery, I hope you have confidence in this point. (B) lumbar disc herniation is a common disease, multi-morbidity, through the daily exercise can completely prevent and recover. (c) lumbar disc herniation should not be treated surgically as far as possible, because the disc is normal tissue, surgery can only remove a part of the protrusion, there is a problem of recurrence, the best surgery is total removal, which is the same as repairing a bicycle, the bicycle axle parts are broken, if you go to repair, the repairer will tell you to replace a new one, you will not hesitate to replace a new one, the same as the intervertebral disc, the best way is to replace it with a new one. A new one, but at present, although science is very advanced, but can not create the same artificial disc and the human body, the best artificial disc can only be used for 10 years, is already the best, you can hardly come across. Therefore, when the doctor removes all your discs and then implants artificial discs, he can only make up for this deficiency by fixing the steel nails, otherwise the general artificial discs will be 3-5 years. If the disc is not implanted and nailed after total removal, just like a bicycle, if the parts are broken and not replaced, the axle will soon wear out and you will end up with a new car. People are not cars, they can only be repaired, and when they are repaired, they can only be repaired sparingly, with minor repairs, and not with major repairs. This is the reason why I talked about “surgery as small as possible” in the article “How to choose surgery”. (d) The excellent rate of lumbar disc herniation is 80% under the condition that the doctor strictly controls the surgical guidelines, as a doctor, we hope it is 100% (but this is impossible and can never be achieved), if you understand the surgical complications of lumbar disc herniation, you may have a new understanding of surgical treatment, always thinking that another 20% may happen to you. Remember that surgery carries risks. (E) Indications for surgery 1. regular conservative treatment is ineffective 2. pain prevents you from working and living normally 3. limb paralysis and incontinence (very rare) 4. no matter how big or serious CT or MRI shows, as long as the symptoms are not obvious it is not an indication for surgery.