I. Etiology and pathology Due to degeneration of the nucleus pulposus and annulus fibrosus. In the early stage, it manifests as loosening and instability of the intervertebral disc. As the disc protrudes backward, radicular symptoms occur due to irritation of the sinus vertebral nerve, or irritation and compression of the spinal nerve roots and cauda equina, manifesting as perineural symptoms and signs. When the nucleus pulposus enters the spinal canal through the posterior longitudinal ligament fissure, it is called a herniated disc. According to the location of the herniated nucleus pulposus, it can be divided into 1. lateral type, which is mainly characterized by radicular symptoms and manifests as reflex pain in the lower limbs. 2.Central type Mainly manifests multi-following performance and perineal symptoms caused by cauda equina compression, such as loss of control of urination and defecation, impotence, etc. 3. Paracentral type has both radicular and cauda equina symptoms. 4.Extreme lateral type Mainly manifested as radicular symptoms. 5. Root canal type Root symptoms, mainly manifested as root symptoms. However, the nerve under pressure is the upper nerve root. According to the degree of protrusion, it can be divided into four types: bulging, protruding, prolapsing and free. Bulge: The nucleus pulposus protrudes into the spinal canal and the fibrous ring ruptures or partially ruptures, but the nucleus pulposus does not break through the fibrous ring. Protrusion: the nucleus pulposus breaks through the fibrous ring, but the posterior longitudinal ligament is intact. Prolapse: The nucleus pulposus passes through the posterior longitudinal ligament fissure and partially or largely enters the spinal canal. Free: The nucleus pulposus breaks through the posterior longitudinal ligament and enters the spinal canal, and may move longitudinally in the spinal canal. Sometimes, it may break through the dura and enter the subarachnoid space. Sometimes it can produce cauda equina symptoms. Diagnosis 1.Inquire whether there is any history of trauma, whether there are triggering factors, the location and nature of pain, and the relationship between rest and movement on pain. Spinal examination 3. Neurological examination Sensory fading and weakening area, toe dorsiflexion muscle strength measurement. The reflexes should be enhanced and diminished. Determine the site of protrusion and damaged nerves, and perform electromyography and evoked potential examination if necessary. 4.Frontal and lateral x-ray of lumbar spine or MRI of spine, except other disorders. 5. The diagnosis of lumbar disc herniation should be based on medical history and physical examination. Other disorders such as cauda equina tumor, lumbar spinal stenosis, lumbar spondylolisthesis, etc. should be distinguished. CT and MRI examinations are feasible. 1. Non-surgical treatment, including: (1) rest in a hard bed; (2) pelvic belt traction For those who are obviously unable to walk, traction should be continued for 3 to 4 weeks and then plaster lumbar circumference should be fixed for 8 to 10 weeks. (3) In chronic cases, massage, physiotherapy and lumbar back support are feasible; (2) Surgery, indications: (1) low back pain and lower extremity radiating pain, which is ineffective by regular non-surgical treatment and affects work and normal life; (2) acute attack or aggravation of symptoms and cauda equina symptoms; (3) combined with other diseases, such as lumbar spinal stenosis, etc. Surgical methods: (1) anterior lumbar disc removal; (2) percutaneous disc chemical nucleolysis; (3) posterior disc removal, such as small openings, hemi-plate decompression, total plate decompression, etc. (4) Percutaneous disc removal for young simple disc herniation.