Three factors contribute to the occurrence of “lumbar protrusion” 1, physiological degeneration of the lumbar intervertebral disc degenerative changes in the intervertebral disc has begun at about 20 years of age, fibrous annulus degeneration, thickening, elasticity decreased; 30 ~ 40 years of age, the intervertebral disc to further loss of elasticity and expansion properties. The intervertebral discs do not have blood circulation, poor repair ability, coupled with the spinal column every year 4-5 million times the frequency of activities so that the lumbar intervertebral discs are subjected to stress from different directions, prone to atrophy, elasticity and other degenerative lesions. 2, trauma, strain injury, trauma and accumulated strain injury is an important cause of lumbar disc herniation. Although the lumbar spine is physiologically anterior convex, the intervertebral disc is thin and thick, when people bend over, the nucleus pulposus moves backward and produces resistive elasticity, and the size of its elasticity is directly proportional to the size of the weight-bearing pressure. If the weight-bearing pressure is too large, the degeneration of the annulus fibrosus and its own existing defects, the nucleus pulposus may break through the annulus fibrosus and bulge, protrude or prolapse. 3, the cold intervertebral disc by the cold so that the lumbar back muscle spasm and small blood vessel contraction. Local blood circulation is reduced, which in turn affects the nutrition of the intervertebral disc. At the same time, muscle tension and spasm lead to increased internal pressure of the intervertebral discs, especially for the discs that have been degenerated, which can cause further damage, resulting in herniation of the nucleus pulposus. Non-surgical treatment 1, bed rest Bed rest is a very simple but effective measure for patients with lumbar disc herniation, and it is the basis of non-surgical treatment. Lumbar girdle and supportive belt Lumbar girdle and supportive belt for lumbar disc herniation patients are mainly aimed at braking, which can make the damaged lumbar discs get sufficient rest locally, and create good conditions for the recovery of patients’ body. Traction therapy Traction therapy is one of the commonly used therapies for patients with lumbar disc herniation, and the method of traction therapy has gained great development at present. Tui na therapy Tui na therapy is a part of Chinese medicine, which has the advantages of simple method and few complications. Acupuncture and Moxibustion Therapy Acupuncture and Moxibustion Therapy includes Body Acupuncture Therapy, Auricular Acupuncture Therapy, Electroacupuncture Therapy, Blood Stabbing and Cupping Method, Hand Acupuncture Therapy, Scraping Therapy and so on. 6.Closure therapy It includes pain point closure therapy, epidural cavity closure therapy, pushing the interstitial nerve root closure and other methods. Advantages of non-surgical therapy: safe, simple, non-invasive, less pain for patients, effective for patients with short history and mild clinical symptoms and signs. Disadvantages of non-surgical treatment: the treatment effect is relatively poor, the effect is slow, the treatment is not complete, must grasp the degree of lesion and the timing of treatment. When the non-surgical treatment is ineffective for more than three months and seriously affects the work and life, the patient should give up early and consider surgical treatment, and the blind and long time conservative treatment often delays the diagnosis and treatment or causes complications. Surgery 1. Nucleus pulposus (Nucleus pulposus) Injecting drugs into the intervertebral disc or its vicinity to dissolve, absorb, and discharge the disc tissues that oppress the nerves and relieve the nerve compression. So far, the main drugs used in Nucleus pulposus chemical dissolution therapy are papaya curdling protease and collagenase, both of which are highly selective for intervertebral disc tissues. Among them, papaya curdling protease can rapidly reduce the molecular weight and viscosity of water-soluble proteins in the nucleus pulposus to make it dissolve, whereas collagenase can dissolve the nucleus pulposus and annulus fibrosus. These two enzymes have a strong selective effect on the intervertebral disc tissues, mainly acting on the nucleus pulposus, and they have little effect on the tissues outside the intervertebral disc, such as the posterior longitudinal ligament, vertebral body, nerve cells and cartilage. Advantages: local anesthesia, the operation is relatively simple, only 10-15 minutes; will not cause epidural fibrosis and scarring. Disadvantages: There is a possibility of producing allergic reactions. The effective rate is about 70%, but it is not suitable for all patients, and requires experienced orthopedic surgeons to strictly grasp the indications for surgery. 2, lumbar discoscopy nucleus pulposus removal lumbar discoscopy treatment of disc herniation, the incision length is only 2~3 cm, without extensive stripping of the paraspinal muscles, without interfering with the normal biomechanical structure of the spine, without affecting the stability of the lower lumbar segment, the patient can be walking on the ground 3~5 days after the operation. Patients can walk 3~5 days after the surgery. Surgery can also be performed for disc prolapse accompanied by bony stenosis, disc ossification or cartilage nodule type disc prolapse. Advantages: small damage, quick recovery, maximize the stability of the spine. Disadvantages: Expensive equipment and high technical requirements for surgical personnel. According to domestic and foreign reports, the effective rate is 86-100%. 3.Nucleus pulposus removal of lumbar intervertebral disc Suitable for lumbar intervertebral disc herniation diagnosis is clear, by the formal non-surgical treatment for 6 months is ineffective; recurrence of severe symptoms; sudden lumbar intervertebral disc herniation radicular pain severe can not be relieved, and continue to aggravate; lumbar intervertebral disc herniation combined with the loss of nerve root function or cauda equina dysfunction. Advantages: wide exposure, complete decompression, easy operation, especially suitable for lumbar disc herniation combined with centralized spinal stenosis. Disadvantages: excessive removal of posterior spinal structures may affect the stability of the spine. According to domestic and international reports, the effective rate is 92-100%. Points for prevention 1, when lifting heavy objects from the ground, you should bend your knees and squat down to avoid bending over and increasing the burden on the lumbar region; when taking heavy objects, your body should be as close as possible to the object so that it is close to the abdomen, and at the same time, you should grasp the balance and should not exert too much force. After a long time of bending, not violently straight back. 2, the bed should not be too soft , sleep should be able to maintain the physiological curvature of the spine. 3, to avoid excessive mental tension, life should be regular, not sedentary, appropriate physical exercise, purposefully strengthen the lumbar and back muscles exercise, so that the muscles are strong and powerful, the formation of “muscle girdle”, to reduce the load on the intervertebral discs. 4, to adapt to seasonal climate change, to prevent wind, cold and rain, do not lie in a damp place. 5.Once an acute lumbar sprain occurs, it should be rested appropriately and treated in time.