Eleven spinal surgeries were performed this week, including five cervical and six lumbar. There were five cases of lumbar disc herniation and one case of lumbar spondylolisthesis in the lumbar spine surgeries, and two of the patients with lumbar disc herniation developed cauda equina syndrome prior to admission, i.e., acute urinary and faecal difficulties and urinary retention were caused by the repeated delays in the surgeries. Although the patients felt a lot more relaxed after the surgeries, and the severe pains of the legs were completely relieved, the Although the patient felt much more relaxed after the operation and the severe pain in the legs was completely relieved, the numbness in the perineum and urination and defecation only gained a small part of improvement, and she cannot take care of herself yet. Ai Fuzhi, Department of Orthopedics, Guangzhou General Hospital, Guangzhou Military Region So, when should patients with lumbar disc herniation take surgical treatment? Lumbar disc herniation is the first common disease in spinal surgery, with a very high clinical incidence, and the most common surgery in spinal surgery, followed by cervical spondylosis. The most common clinical symptoms of lumbar disc herniation: radiating pain in one side of the lower limb, with or without low back pain; physical examination: positive straight leg raising test; lumbar magnetic resonance (MR) shows posterior lateral herniation of the discs in the lower lumbar vertebrae (most commonly L4/5 and L5/S1), which compresses the nerve roots. Lumbar disc herniations are generally categorized as bulging, protruding, or prolapsing by imaging. For patients with simple bulging discs, surgical treatment is generally not required because clinical symptoms are generally mild. Through regular bed rest, physical therapy and other symptomatic treatments such as dehydration and pain relief during the acute phase and proper functional exercises during the stabilization phase, prolonged healing can generally be achieved, and many patients do not need surgery for life. For patients with herniated discs, the symptoms of clinical pain in upper and lower limbs are generally more serious, and at the initial onset, if the herniation is not very serious, it is generally possible to obtain stabilization through regular conservative treatment (as mentioned above), and whether or not to open the surgery in the future depends on the direction of the development in the future, such as the herniation is serious, and it is ineffective to receive timely surgical treatment through conservative treatment, so as to avoid delaying the condition and the effect of the surgery is not good. . For patients with disc prolapse, basically surgery is needed because the prolapsed nucleus pulposus can not be self-retracted by any conservative method, so it is impossible to solve the compression of the nerve root, and the clinical symptoms of patients with acute prolapse are very serious and the pain in the lower limbs is intolerable, so it is necessary to undergo surgery in a timely manner. For the lumbar disc herniation is serious, after regular conservative treatment is invalid or disc prolapse patients, should be operated as soon as possible. If the surgery is delayed, 100% functional recovery will not be possible if the following problems occur: toe dorsiflexion weakness, drop foot, muscle atrophy of the lower limbs, urinary and defecation disorders (i.e. cauda equina syndrome), etc. This kind of situation is not uncommon in clinics, which may be related to the patient’s psychological fear of the risk of the surgery, and the fear that the surgery may cause paralysis of the lower limbs, and many other factors. However, once the various conditions mentioned above occur, the effect of the surgery will be discounted, which could have been fully recovered, but after the emergence of these problems, although the pain in the lower limbs can be completely relieved after the surgery, the various problems mentioned above will be partially or even wholly residual, and the improvement of symptoms will be limited, which will bring about the inconvenience in life. So, when exactly should I receive surgical treatment? Persistent lower extremity pain that still cannot be effectively relieved after regular conservative treatment. Don’t be afraid of the question of surgical risk. Surgery of the lumbar spine is one of the simplest procedures in the hands of a specialized and skilled spine surgeon, and for us spine surgeons, it is a procedure that is done almost every day without nerve damage or paralysis. Don’t shy away from it, and try not to put it off until all of the above have occurred, or the loss will be more than worth it.