Lumbar disc herniation is a disease in which the nucleus pulposus protrudes and compresses the nerve roots after the rupture of the fibrous ring, causing mainly low back and leg pain. The lumbar intervertebral disc is equivalent to a micro-movement joint and is composed of a hyaline cartilage plate, a fibrous ring and the nucleus pulposus, which are distributed among the lumbar vertebrae. When the lumbar intervertebral disc ruptures due to degenerative changes or trauma, the nucleus pulposus prolapses from the rupture and compresses the lumbar spinal nerve, resulting in radiating pain in the back and legs. The incidence of lumbar disc herniation is highest in lumbar 4-5 and lumbar 5-sacral 1, accounting for about 95%, and the most common symptom of patients is pain, which can be manifested as low back pain, sciatica, etc. I. Common manifestations 1. low back pain; 2. muscle paralysis; 3. abnormal sensation and numbness; 4. radiating pain in lower limbs. Imaging examination 1.Lumbar spine X-ray; 2.CT examination; 3.Magnetic resonance imaging (MRI) examination; 4.Other electrophysiological examination (electromyography, nerve conduction velocity and evoked potential). The diagnosis of typical cases, combined with medical history, physical examination and imaging examination, is generally not difficult, especially today when CT and MRI techniques are widely used. Non-surgical treatment Most patients with lumbar disc herniation can be relieved or cured by non-surgical treatment. The treatment principle is not to return the degenerated and herniated disc tissue to its original position, but to change the relative position of the disc tissue and the compressed nerve roots or to partially retract them, so as to reduce the pressure on the nerve roots, release the adhesions of the nerve roots and eliminate the inflammation of the nerve roots, thus relieving the symptoms. Non-surgical treatment is mainly suitable for: (1) young people, first attack or short duration of the disease; (2) people with mild symptoms that can be relieved on their own after rest; (3) people with no obvious spinal stenosis on imaging. (1) Absolute bed rest For the first attack, bed rest should be strictly applied, emphasizing that neither bowel movements nor urination should be performed in bed or sitting up, so as to have better results. After 3 weeks of bed rest, you can get up and move around under the protection of a lumbar girth, and do not bend over and hold things for 3 months. This method is simple and effective, but more difficult to adhere to. After remission, the lumbar back muscle exercise should be strengthened to reduce the chance of recurrence. (2) Traction therapy The use of pelvic traction can increase the width of the intervertebral space, reduce the internal pressure of the intervertebral disc, the protruding part of the disc retracts, and reduce the irritation and compression of the nerve root, which needs to be carried out under the guidance of a professional doctor. (3) Physiotherapy, massage and tui-na can relieve muscle spasm and reduce the pressure within the intervertebral disc, but note that violent massage and tui-na can lead to aggravation of the disease and should be done with caution. (4) Epidural injection of corticosteroids (5) Chemical dissolution of the nucleus pulposus 2.Percutaneous nucleus pulposus excision/ laser vaporization of the nucleus pulposus The nucleus pulposus is partially crushed and sucked out or laser vaporized by special instruments entering the intervertebral space under X-ray surveillance, thus reducing the pressure in the intervertebral disc to relieve the symptoms. It is not suitable for patients with combined lateral saphenous stenosis or obvious herniation and those whose nucleus pulposus has prolapsed into the spinal canal. 3.Surgical treatment (1) Indications for surgery ①The history of more than three months, strict conservative treatment is ineffective or conservative treatment is effective, but frequent recurrence and heavy pain; ②The first attack, but the pain is severe, especially in the lower extremities, the patient has difficulty moving and sleeping, and is in a forced position; ③The combined expression of the cauda equina nerve compression; ④The presence of single nerve root paralysis, accompanied by muscle atrophy, muscle strength loss; ⑤The combined spinal canal stenosis. (2) Surgical method A posterior lumbar back incision with partial laminectomy and synovectomy, or discectomy through the intervertebral space. For central disc herniation, after laminectomy, epidural or intradural discectomy is performed. In cases of combined lumbar instability and lumbar spinal stenosis, simultaneous spinal fusion is required. In recent years, minimally invasive surgical techniques such as microdiscectomy, microendoscopic discectomy, and percutaneous foraminoscopic discectomy have reduced surgical damage and achieved good results. Fifth, disease prevention lumbar disc herniation is caused by accumulation of injuries on the basis of degenerative changes, accumulation of injuries will aggravate the disc case workers need to pay attention to the height of the table, chair, and regularly change the posture. Occupational work requires frequent bending action, should be regularly stretching, chest activities, and the use of a wide belt. Should strengthen the lumbar back muscle training, increase the intrinsic stability of the spine, long-term use of waist circumference, especially need to pay attention to lumbar back muscle exercise to prevent the adverse consequences of disuse muscle atrophy. If you need to bend over to get something, it is best to use hip flexion, knee flexion squatting way to reduce the pressure on the back of the lumbar intervertebral disc.