Patient question: disease: lumbar disc herniation Hospital department: 260 hospital orthopedic content: examination and laboratory tests: after taking CT diagnosis report: localization image shows lumbar vertebrae in line with good, physiological curvature slightly straight, each lumbar vertebral body morphology and bone density does not see obvious abnormalities. l3 ~ L4 disc morphology does not see obvious abnormalities; L4 ~ L5, L5 ~ S1 intervertebral disc posterior direction of the spinal canal limited protrusion of soft tissue The dural sac was compressed, the anterior and posterior diameters of the spinal canal were narrowed, and patchy calcification was still seen at the posterior edge of the L5~S1 disc. No change in paravertebral tissues. Impression: 1. L4~L5 disc protrusion with secondary spinal stenosis 2. L5~S1 disc protrusion with calcification with secondary spinal stenosis After the results came out, acupuncture and massage were performed, and the symptoms of back pain disappeared. In October 2012, due to work strain, the pain in the lower back started, accompanied by pain in the left rear hip. This time, the localization film showed straightening of the lumbar curvature, no significant abnormalities in the morphology and density of the vertebrae, and no significant narrowing of the lumbar 1-sacral 1 intervertebral space. The transverse axial image showed myxoid posterior protrusion of the lumbar 4-5 intervertebral disc, protrusion of the lumbar 5-sacral 1 intervertebral disc to the left and right, compression of the dural sac, and narrowing of the lumbar 5-sacral 1 spinal canal. No clear abnormalities were seen in the paravertebral soft tissues. Treatment: Acupuncture and massage were performed after the results came out in May this year, and the symptoms of lumbar pain disappeared. In October 2012, due to work strain, the pain in the lumbar region began, accompanied by pain in the left rear hip. The doctor recommended surgery, but I did not dare to operate and underwent conservative treatment, and after acupuncture and massage treatment, the pain in my lower back stopped and so did the pain in my hindquarters. I’m not sure if my condition has progressed from the CT in May to the CT in October. Is the protrusion accompanied by calcification caused by a protrusion that has been protruding for a long time before? Please help me to see how to treat my condition. Is it possible to continue conservative treatment (my symptoms have not been very obvious) or should I undergo surgery, and which is the best choice? Please tell me if the diagnosis is not consistent and my condition is serious, is it feasible without surgery? Or is surgery necessary? I’m still young and I’m worried about the after-effects of surgery. The diagnosis of lumbar disc herniation is clear. The protruding disc is calcified on the film, indicating that the protrusion has been there for a long time. Most of the herniated discs do not require surgery, only a few patients who have undergone strict conservative treatment (3 months) and have worsening neurological symptoms and weakness of the lower limbs and cauda equina syndrome need surgery. In your case, there is an improvement after conservative treatment, and you can temporarily do without surgical treatment. When it gets worse and conservative treatment is not effective, it is not too late to consider surgical treatment. The diagnosis in May showed calcification, but the diagnosis in October did not show calcification. Do you think I’ve had a protrusion for a long time? And I have spinal stenosis, is it very serious? Patient question: Dr. Zhou, you said that only patients with lower limb weakness and cauda equina syndrome need surgery. I now feel that my legs are not as sensitive as before, my left rear hip is not as sensitive as before, and my penis is not as sensitive as before after erection, is it already considered cauda equina syndrome? Doctor’s reply: Hello From the film, it seems that the lumbar disc protrusion should be relatively long. However, quite a few patients have a herniated lumbar disc but are not uncomfortable per se and do not need treatment. I wonder if the length of your current erection has any effect? And can you hold your urine? If the erection time is shortened and the urine appears to be unable to be held, then we suggest that you have further examination by performing MRI or visit the hospital. Patient Question: The erection time is not affected, and the urination is normal. The nerve root on the left side of the lumbar 3-4 disc level is thickened, not excluding nerve sheath tumor. I have a nerve sheath tumor and a herniated disc, how can I treat it? I am eagerly waiting for a reply! Now my left leg starts to go numb when I walk for more than 10 minutes, and I have pain in my right hip. Doctor’s reply: Hello, we need to clarify which cause of your current pain is caused. From the MRI film, it looks like there are problems in lumbar 3-sacral 1. Then, you need to locate which segment is based on the different nerve roots. Need to know the specific area of pain in the left leg, for example, is it outside the calf, inside the calf, or behind the calf belly”? Or is it the thigh? It is important to know which segment is the problem by the specific area. Patient question: The left leg is the back of the thigh and calf, no pain, but numbness, stretching sensation, walking for more than 10 minutes the whole back of the leg is numb, including the sole of the foot is also numb. “What kind of problem are you referring to? My MRI and CT did not show any problem with lumbar 3-sacral 1, only a 3cm nerve sheath tumor on lumbar vertebra 4. Doctor’s reply: If the problem is only in the back of the thighs and calves, it is considered to be caused by a herniated disc in the lumbar spine and not related to a nerve sheath tumor. The herniated disc can be treated conservatively first to observe the effect, if recurrent attacks or weakness in the lower limbs, cauda equina syndrome will require further surgery Patient Question: Doctor, I have already undergone fusion and internal fixation surgery with six nails. I have been discharged from the hospital after twenty-three days of surgery. I was in the hospital for seven days. Now I have this problem, I had a fever up to 38.5 degrees after the surgery. Now the temperature is normal in the morning, always fever in the afternoon, fever to 38 degrees, then the temperature will keep dropping to 37 degrees at six o’clock in the evening, and the temperature at night is 37 degrees. Very confused always feverish. Blood tests: normal white blood cells, normal blood sedimentation, slightly high platelets, low red blood cells. I consulted with the attending doctor and he said it could be absorption fever or a reaction caused by the body’s rejection of the nail. You can tell us what the cause is. It is now twenty-three days after surgery, but I still can’t get up by myself with the lumbar girth, so I need help to get up, and my right rear end hurts after I get up and walk. The pain starts again after walking more. What is the reason for this? Doctor’s reply: Hello Preliminary consideration Infection. At that time, you were advised not to operate for the time being? Why did you rush to operate later? I suggest you check the blood sedimentation and C-reactive protein, if they are very high, you should consider infection. You send me the post-operative film also see it