What are the signs of lumbar disc herniation? General signs: mainly refers to lumbar and spinal signs Common manifestations of the disease include: 1. gait: in the acute stage or when nerve root compression is obvious, the patient may have a limp, a hand on the waist or the affected foot is afraid of weight bearing and jumping gait, etc., while light cases may be no different from normal people 2. lumbar curvature changes: in general cases, the physiological curve of the lumbar spine disappears, the flat waist or foreshortening decreases, and in a few cases, there is even a posterior convexity deformity (mostly). 3, scoliosis: generally have this sign, depending on the relationship between the site of the herniated nucleus pulposus and the nerve roots and the spine curved to the healthy side or curved to the affected side, such as the site of the herniated nucleus pulposus is located in the spinal nerve roots, because the spine curved to the affected side can reduce the tension of the spinal nerve roots, so the lumbar vertebrae curved to the affected side; conversely, if the herniated nucleus pulposus is located on the outside of the spinal nerve roots, the lumbar vertebrae more curved to the healthy side In fact, this is only a general rule, but many factors, including the length of the spinal nerve, the degree of traumatic inflammatory reaction in the spinal canal, the distance of the protrusion from the spinal nerve root, and various other reasons can change the direction of scoliosis. 4. pressure pain and percussion pain: the site of pressure pain and percussion pain basically corresponds to the vertebral segment of the lesion, and is positive in about 80% to 90% of cases. Some cases are accompanied by radiating pain in the lower limbs, mainly due to the stimulation of the dorsal branch of the spinal nerve root. The degree of limitation of lumbar range of motion varies greatly depending on factors such as whether it is in the acute phase and the duration of the disease. Clinically, the circumference of the thigh and calf should be routinely measured and the muscle strength of each group of muscles should be tested, and compared with the healthy side and recorded, and then compared after treatment. 7, sensory disorders: the mechanism is the same as the former, depending on the location of the affected spinal nerve roots and the abnormal sensation of the innervation area, the positive rate of more than 80%, including the posterior type of 95%. In the early stage, the symptoms are mostly skin irritation, and gradually numbness, tingling and hyperalgesia appear, but complete loss of sensation is not rare. However, if the cauda equina nerve is involved (central and paracentral type), the range of sensory impairment is more extensive. Reflex changes: It is also one of the typical signs of the disease. When the lumbar 4 spinal nerve is involved, knee-jerk reflex disorder may appear, which is active in the early stage and then rapidly becomes hyporeflexic, and the latter is more common in clinical practice. Special signs: the signs obtained through various special examinations The main ones with greater clinical significance are: 1. flexion neck test (Lindner’s sign): also known as Lindner’s sign, the patient is asked to stand, lie on his back or sit, the examiner places his hand on the top of the head and makes it bend forward, if the lower limb of the affected side appears radiating pain, it is positive, and vice versa is negative, the positivity rate of the spinal canal type is up to 95% or more, the mechanism is mainly The mechanism is mainly due to the upward displacement of the dura mater while flexing the neck, resulting in the spinal nerve roots in contact with the protrusion suffer from the pull. 2, straight leg elevation test: the patient lies supine, so that the affected knee is lifted upward in a straightened state, and the angle of passive elevation is measured and compared with the healthy side, this is called the straight leg elevation test, this test has been recognized since 1881 when Forst first proposed it, the test is more useful for the lower nerve root, the higher the positive detection rate (the smaller the lifting angle). In addition, the larger the protrusion, the more extensive the edema and adhesions at the root cuff, the lower the lift angle. Under normal conditions, the lower extremity can be lifted above 90°, but the angle decreases slightly with age. Therefore, the smaller the lift angle, the greater the clinical significance, but it must be compared with the healthy side; in bilateral cases, 60° is generally used as the dividing line between normal and abnormal. 3, healthy limb elevation test (also known as Fajcrsztajn sign, Bechterew sign, Radzikowski sign): when the healthy limb is elevated straight leg, the nerve root sleeve of the healthy side can pull the dural sac to distal displacement, so that the nerve root of the affected side also moves downward, when the affected disc is herniated in the axillary part of the nerve root, the nerve root is restricted to distal movement, causing pain If the herniated disc is in the shoulder, it is negative. When the patient is lying on his back during the examination, sciatica on the affected side is positive when the straight leg is raised on the healthy side. 4.Laseque’s sign: Some people combine this sign with the previous one into one category, while some others advocate a separate description, that is, the hip and knee joints are placed in flexion at 90°, and then the knee joint is straightened to 180°, during which if the patient has radiating pain at the back of the lower limb, it is positive. The mechanism is mainly due to the stimulation and pulling of the sensitive sciatic nerve when extending the knee. 5, straight leg elevation test: also known as Bragard’s sign, that is, when operating the straight leg elevation test up to a positive angle (to the patient complains of radiating pain in the limb), and then the affected foot to dorsal flexion to increase the pull on the sciatic nerve, positive patients complain of increased radiating pain in the sciatic nerve, the purpose of this test is to exclude the influence of myogenic factors on the straight leg elevation test. 6.Supine abdominal lift test: the patient takes the supine position, does the abdominal lift action, makes the hip and back leave the bed. At this point, if the complaint of radiating pain in the sciatic nerve of the affected limb appears, it is positive. 7.Femoral nerve pull test: the patient takes the prone position, the knee joint of the affected limb is completely straight, the examiner lifts the straightened lower limb so that the hip joint is in the hyperextension position, and when the hyperextension reaches a certain level and pain occurs in the femoral nerve distribution area in front of the thigh, it is positive. This test is mainly used to examine patients with lumbar 2 to 3 and lumbar 3 to 4 disc herniation, but in recent years it has also been used to detect cases of lumbar 4 to 5 disc herniation, and its positive rate can be as high as 85% or more. 8, other tests: such as N nerve or common peroneal nerve compression test, lower limb rotation (internal or external rotation) test, etc., mainly used for other causes of sciatica disorders.