1. What tests can diagnose lumbar herniation? No single test can diagnose lumbar disc herniation. CT examination shows the site, size and shape of the herniated disc and the image of the nerve root and dural sac being displaced by pressure, and also shows the thickening of the vertebral plate and ligamentum flavum, hypertrophy of the small joints, narrowing of the spinal canal and lateral saphenous fossa, etc., and can reconstruct the three-dimensional shape of the spinal canal and root canal with three-dimensional technology. The three-dimensional technique can reconstruct the three-dimensional shape of the spinal canal and root canal. In addition, myelography with water-soluble contrast agent combined with CT examination can improve the accuracy of diagnosis.MRI examination is important for the diagnosis of intervertebral disc herniation. By using sagittal images at different levels and multi-directional images of the involved disc, the morphology of the herniated disc and its relationship with the surrounding tissues can be observed. For patients who cannot undergo MRI, myelography can also be performed with high accuracy. 2.Why does the doctor want me to have X-rays, CT and MRI, but can’t I have just one? X-rays, CT and MRI have their own advantages and disadvantages and are complementary. Patients suffering from lumbar disc herniation will first go to the hospital for X-ray examination, which can exclude other bony lesions. For patients with lumbar disc herniation, CT examination is considered when bone abnormalities (narrow fracture, epiphyseal dissection) are suspected. Magnetic resonance imaging (MRI) is an examination method for soft tissue (disc herniation site, direction, and spinal nerve root compression). In addition to clinical history and physical examination, MRI has been a common examination method for diagnosing lumbar disc herniation. 3. Can the diagnosis of lumbar herniation be confirmed only by taking a film? The diagnosis of lumbar disc herniation can not be confirmed by X-ray examination, and the diagnosis of lumbar disc herniation can only be made after comprehensive consideration of clinical symptoms, physical examination and imaging examination results, and differentiation from other diseases. 4. If the imaging examination is normal, can lumbar herniation be ruled out? The diagnosis of lumbar disc herniation should be based on a combination of clinical symptoms (low back pain and lower limb radiating pain), physical examination (signs corresponding to nerve damage, sensorimotor disorders, and abnormalities in urination and defecation), and imaging examination (showing the location, direction, and degree of lumbar disc herniation). A normal imaging examination cannot completely exclude lumbar disc herniation. Since imaging examinations have a certain false positive rate, but MRI examination has a low false positive rate (less than 10%) for the diagnosis of lumbar disc herniation. 5. Which diseases are easily confused with lumbar herniation? How to differentiate? (1) Lumbar spinal stenosis. Intermittent claudication is a typical symptom of lumbar spinal stenosis. Patients complain of soreness, numbness and weakness of the lower limbs after walking for a certain distance, which must be relieved by squatting and resting and can continue walking. Cycling can be asymptomatic and there can be no obvious positive signs on physical examination. In addition to the difference in symptoms and signs, MRI examination can help to differentiate. (2) Lumbar spine tuberculosis. Patients with lumbar spine tuberculosis mostly have symptoms (low fever in the afternoon, night sweats, wasting accompanied by longer-term persistent dull pain in the lumbar region, physical examination can be seen in the lumbar protective ankylosis all activities restricted activities, laboratory tests increased hematocrit, X-ray plain film shows the degree of bone destruction, comprehensive symptoms signs and imaging can be distinguished from lumbar disc herniation. (3) Spinal tumor. Generally elderly patients, may have a history of tumor in other parts of the primary body, persistent nocturnal pain, X-ray and CT examination can clarify the bone destruction, MRI examination shows the extent of soft tissue invasion, size. (4) Pelvic outlet syndrome. Pelvic outlet syndrome is a symptom similar to that of lumbar disc herniation caused by irritation or compression of the sciatic nerve passing through the pelvic outlet. It is mainly a symptom of sciatic nerve trunk irritation with radiating pain along the sciatic nerve walk starting from the buttocks and accompanied by motor, sensory or reflex disorders in its innervated area. Physical examination and imaging findings can help to differentiate, and local closure can also identify lumbar disc herniation. (5) Third lumbar transverse process syndrome. The third lumbar transverse herniation syndrome usually has a history of trauma. Physical examination may reveal significant pressure pain at the tip of the transverse process of the third lumbar vertebra and local muscle spasm or muscle tension. Physical examination and imaging findings can help to identify, and local closure can also identify lumbar disc herniation. (6) Lumbar myofasciitis. The most frequent onset in middle-aged people is due to overuse of muscles or due to strenuous activity. On examination, there is lateral bending and limitation of movement due to protective muscle spasm and obvious pressure points; there is no obvious abnormality on impactological examination. 6.Does a lumbar herniation without symptoms also need treatment? If there is no symptomatic lumbar disc herniation, the diagnosis is not established if it is only the result of imaging examination. If a lumbar disc herniation is diagnosed, the symptoms disappear after active conservative treatment. Pay attention to the following points in daily life: (1) Sleeping on a hard bed. Sleeping on a hard bed can reduce the pressure on the intervertebral discs . (2) Do not do excessive bending, do not bend when lifting heavy objects, you should first squat to get the heavy objects, and then slowly get up, and avoid long bending and excessive weight bearing. (3) The same position should not be maintained for too long, appropriate in situ activities or low back activities. (4) Swimming (breaststroke), backward walking and so on can carry on the neck waist back muscle strength exercise. 7.What are the treatment methods for lumbar protrusion? On the whole, most patients with lumbar disc herniation are treated conservatively, and there are various methods of conservative treatment, which are chosen according to the different conditions of the patients. First of all, bed rest is the most basic and important basic treatment, because the intervertebral disc plays the role of supporting our weight in normal life, and when standing upright or sitting, the disc has to bear a lot of weight, and the pressure inside is very high at this time, and the pressure on the nerve roots is correspondingly heavy. Most people are not very heavy lumbar disc herniation, such as bulging, after herniation through bed, the entire spine completely relaxed, the pressure of the intervertebral disc to reduce the squeeze on the nerve root, at the same time, some patients after the intervertebral disc compression of the nerve root, the nerve root itself will be some inflammation, after you rest in bed, the pressure of the intervertebral disc is light, the nerve swelling will slowly recede, in fact, also The purpose of treatment is actually achieved. There are more than a dozen ways to treat lumbar herniation, 80% of which are conservative. If conservative treatment does not solve the problem, we should seek some other methods. Some medications can also be useful. These medications mainly target the inflammatory response, reduce the edema of the nerve roots, reduce the local inflammatory response, and provide pain relief through these measures. The choice of surgical modality is detailed in my previous article on science (see Prof. Haichong for details). 8. Various lumbar protrusion treatment devices, are they effective? There are a large number of advertisements on TV, newspapers and other media for instruments for the treatment of lumbar disc herniation, but the efficacy of these advertised products is not exact, and most of them are overly exaggerated. In general, patients with lumbar disc herniation will feel hardness in their lower back and muscle spasms. The actual fact is that you can find a lot of people who are not able to get a lot of money to spend on their own. Some instruments rough treatment process, and even aggravate the symptoms of lumbar disc herniation. The patient should still be cautious, should consult the regular hospital physical therapy department for regular scientific conservative treatment. 9, there is the treatment of lumbar protrusion of the secret recipe? There is no secret formula, special medicine or prescription for the treatment of lumbar disc herniation. The disease should be diagnosed and treated scientifically. The treatment method is mainly divided into conservative treatment and surgical treatment. Conservative treatment is mainly through drugs, rest, physical therapy to reduce the symptoms, but conservative treatment can not fundamentally solve the problem of lumbar disc herniation. Surgery is suitable for patients whose symptoms are more serious and have been invalidated by strict conservative treatment, or whose symptoms are repeatedly aggravated. There are also many different surgical methods, and the doctor will choose the surgical method according to the patient’s age, gender, weight, occupation, subjective requirements, and the degree and extent of lumbar disc herniation, nerve damage and other comprehensive factors.