When conservative treatment for lumbar disc herniation is ineffective, many people have to choose surgical treatment. The surgical methods for lumbar disc herniation are briefly described. I divide the surgical methods for lumbar disc herniation into 4 categories: I. Simple disc removal (small window treatment) A small hole of about 1.0cm diameter size is made in the lumbar vertebral plate to remove the intervertebral disc. This operation is the most classic operation for lumbar disc herniation because it is less invasive, has fewer complications, and has less impact on the human body. However, since only part of the disc is removed, there is a possibility of recurrence, but if the indications for surgery are mastered, the recurrence rate is very low. For patients with lumbar disc herniation, this procedure is the best choice. Sometimes, because of problems such as bilateral disc herniation, or huge disc herniation, hemilaryngectomy and total laminectomy are developed on this basis to prevent damage to the nerves during surgery. (Only the window opened on the bone is bigger) For the above surgery, if the small articular protrusion (equivalent to the connection between the bicycle chain, if taken, the bicycle chain is broken) is not removed intraoperatively, it is completely unnecessary to do steel nail fixation and disc fusion (bone is implanted between the two vertebrae to make the two vertebrae fuse), the skin incision of this surgery is usually about 5-10 cm. Minimally invasive treatment In order to make the skin incision smaller, discoscopy (minimally invasive surgery in which a 2 cm diameter tube is placed inside a small skin incision, a mirror is placed inside the tube, and the disc is removed from the tube under the mirror) has emerged. The skin incision for this procedure is limited to 2 cm. Based on this, in order not to make an incision in the skin, the technique of puncture treatment (disc melting technique) emerged. Minimally invasive treatment: The current lumbar discoscopy technique is relatively mature. Disc melting technology early application of chemical drug melting due to many complications is rarely used, the main application of radiofrequency ozone ablation technology treatment (that is, the herniated disc is melted, in fact, the extent of this melting is still under study). Minimally invasive treatment (discoscopy or radiofrequency ozone ablation technology) is less invasive and has few complications if operated skillfully, but the relative indications are very strict due to the restricted operation. In order to completely prevent the recurrence of the disc after surgery, some doctors remove all the protruding discs and implant bones between the two vertebrae after disc removal (usually taken from the iliac bone of the person, the bone of other people is more difficult to heal), because it takes some time for the implanted bone to heal, so the early stage is bed rest for 3 months after surgery. At present, the implanted bone is fixed with a steel nail and can be moved out of bed at an early stage, but in the later stages, injury to the adjacent disc may occur due to excessive movement of the adjacent disc. The lumbar spine is like a segment of a spring, and if one part of it goes wrong and fixes the middle of this segment, then the movement of the whole segment will be limited. And the spring near the fixed part is prone to fracture due to excessive weight bearing, and there is no good medical solution to this problem. Fourth, laminectomy + artificial disc implantation + steel nails fixed after the implantation of bone this disc can not move, now scientists have invented artificial disc, but very regrettable, artificial disc can be used for more than 10 years is very rare, more than 90% of 5 years can not be used, so the implantation of artificial disc will need steel nails and then fixed to reduce the activity, (in fact, do not let the activity) so that you can use lifelong But you will never be able to move this disc. The benefits of discectomy + artificial disc implantation + nail fixation are: to solve the pain caused by the herniated disc and the recurrence after partial discectomy, and also to eliminate the need for surgery to remove the bone from your body, eliminating the need for you to suffer the pain of secondary surgery. However, there is no good solution for this surgery with huge damage and relatively many complications, especially late complications. For the above surgical methods, you may not understand all of them due to medical terminology, but let’s make an analogy you may understand it simply. There are three ways to repair a hole in a car tire: (1) simply patch it (equivalent to simple discectomy); (2) play a little fluid in the tire, temporarily available without patching (equivalent to minimally invasive surgery), and later to patch; (3) replace it with a new one, or with the wheel or even the car axle together. (equivalent to discectomy + artificial disc implantation + steel nail fixation) In fact, discectomy + artificial disc implantation + steel nail fixation is only suitable for vertebrae with displacement (or slippage, arch root disconnection,) or intervertebral instability. For simple disc herniation there is no need for such complex surgery. Like a hole in a car tire, the vast majority of people just need a patch, and for a very small number of people, a new tire or a new car is possible. The human intervertebral disc can only be repaired and reused because it cannot be replaced, and most of the time a tire patch does not have a significant impact on the useful life of the tire. In fact, it is rare for a herniated disc to recur after surgery, so there is no need to worry too much about this. Most people generally have only one herniated disc, but some people may have several herniated discs, but the surgery can be done as long as the symptomatic disc (generally professional orthopedic surgeons can find out which disc is symptomatic), not to remove the adjacent discs, each person has more than 20 discs, if you do an MRI around 40 years old people may have more than one disc herniation, but this is not the surgery In fact, most herniated discs are asymptomatic during their lifetime and do not require treatment at all, and even if they do, less than 10% of people will eventually need surgery. It is like rolling a hole in one tire of a car, there is no need to change all 4 tires or axles unless ……. Most herniated discs will be fine with just a simple discectomy, don’t try to fix everything with one surgery. It’s the same as patching a tire, just patch it, don’t think about putting anything on it or using anything to prevent it from rolling a hole again, just be careful. The same goes for intervertebral discs, only the right way to protect the back and prevent injury in the future and in life and work.