1, diagnosis of lumbar disc herniation: symptoms, physical symptoms and imaging data must be combined together in a comprehensive consideration and comprehensive analysis to ensure the consistency of the three, and its consistency is expressed in the following three aspects. (1) Lateral consistency: In most cases, the side of the lumbar disc protrusion on the image is consistent with the side of the symptoms and physical symptoms. For example, if CT shows that the disc protrudes to the left side, the patient should feel pain in the left leg, and physical examination reveals positive straight leg raising test and strengthening test on the left side. (2) Consistent level: CT shows that the level (gap) of the herniated disc and the involved nerve are consistent with the lesion nerve reflected by the chief complaint area and physical symptoms. (3) The degree is consistent: generally the larger the image shows the herniation, the heavier the clinical performance symptoms and signs, but this is not absolute and is also influenced by the relationship between the location of the herniated disc and the affected nerve root. 2, the localization of lumbar disc herniation diagnosis (1) lumbar 1 to 3 disc herniation: the disc herniation between the thoracic 12 and lumbar 3 vertebrae is called high lumbar disc herniation, less common, compression lumbar 1 to 3 nerves consisting of the closed foraminal nerve and femoral nerve, because the lumbar 1 to 3 spinal nerves do not have their own special physical symptoms, often common innervation iliopsoas muscle or with the lumbar 4 nerve innervation femoral intake muscle group and quadriceps. Sensory disturbances that occur with compression In compression of the lumbar 1 nerve, there is pain and numbness in the upper 1/3 of the oblique band from the groin to the knee. In compression of the lumbar 2 nerve, pain and numbness in the anterior 1/3 oblique band of the mid-thigh. Pain and numbness in the lower anterior 1/3 oblique band of the thigh with compression of the lumbar 3 nerve. Manifestations of dyskinesia when compression occurs Weakness of hip forward flexion caused by iliopsoas muscle involvement. When the internal femoral retractor muscle group innervated by the lumbar 2 to 4 spinal nerves is involved, the hip joint is weak in motion when it is internally retracted from the external booth. When the femoral nerve, which is composed of three spinal nerve fibers from lumbar 2 to 4, is involved, it shows atrophy of the quadriceps muscle, weakness of knee extension, and weakening or disappearance of knee reflex and testicular reflex. (2) Lumbar 3-4 disc herniation: Compression of the lumbar 4 nerve root, the patient has pain and numbness in the back, lumbosacral region and lateral thigh, calf and medial foot. There is weakness in dorsal extension and inversion movements of the foot. Because the lumbar 4 nerve is involved in the innervation of the quadriceps muscle, symptoms and signs such as weakness of quadriceps movement, weakness of knee extension, and weakened or absent knee reflex may also occur. (3) Lumbar 4-5 disc herniation: compression of the lumbar 5 nerve root. Mainly involving the tibialis anterior and extensor muscles, often with pain in the low back and lumbosacral region, and radiating pain and numbness to the thigh, posterior lateral calf to the dorsum of the foot and toes, as well as weakness of the dorsal extension of the parent toe, and in severe cases, foot drop. (4) Lumbar 5 to sacral 1 disc herniation: compression of sacral 1 nerve roots, sensory disorders manifested as pain in the low back, sacrococcygeal region, buttocks, and radiating pain and numbness to the posterior side of the thigh and calf to the bottom of the foot, motor disorders mainly caused by the long and short peroneal muscles involved at the same time caused by the weakening or loss of foot external rotation muscle strength, as well as the calf triceps muscle involvement caused by the ankle joint, foot and mother toe flexion weakness, Achilles tendon The symptoms and signs such as weakening or loss of reflexes of the Achilles tendon due to triceps involvement. The above are the common symptoms and signs caused by the compression of nerve roots by the lateral herniation. The central herniation can compress the nerve root one to two positions below the herniated space or even the entire cauda equina, causing pain and numbness in the lumbar region and both lower extremities, and in severe cases, it can lead to weakness or paralysis of the bladder and rectal sphincter, resulting in symptoms of cauda equina syndrome such as weakness or incontinence of defecation and physical symptoms such as weakening or disappearance of Achilles tendon reflex and testicular reflex, and individual male patients can also develop symptoms of decreased libido and impotence. Foramen ovale and posterolateral herniations may compress the nerve roots emanating from the same or even the previous interspace, causing symptoms and signs. If there is only a herniated disc on the image, but no symptoms or signs consistent with the herniation, the diagnosis of lumbar disc herniation can be made only on the image, but not clinically.