Intervertebral foraminoscopy is a minimally invasive way to treat lumbar disc herniation. Although the incision of the surgery is small and traumatic, many patients who have lumbar disc herniation do not want to open a large knife and want to choose minimally invasive surgery, but they do not know much about this surgery, some patients have concerns about minimally invasive surgery, and some patients have already done intervertebral foraminoscopy, but they are not sure how to maintain after the surgery, and after the surgery, in daily activities such as walking and What do you need to pay attention to in terms of rehabilitation? Is it possible to relieve leg numbness through exercise and at the same time prevent recurrence of the disease? Now we will talk about the knowledge of intervertebral foraminoplasty. 1.Is my condition suitable for foraminoplasty? Interbody foraminoscopy is suitable for all types of disc herniation except for bony spinal stenosis and slipped vertebrae with a disc protrusion of 0.3 cm or more. It should be said that most patients can have the herniated disc removed through minimally invasive interbody foraminoscopy to relieve nerve pressure (incision is only 0.7 cm) and force the numbness and pain in the leg to disappear. 2.What if I can’t do it, can I still do it minimally invasively? In fact, there is no need to be anxious, there is not only one kind of minimally invasive spine surgery, some patients I can do through the foraminoscope from the back of the patient to make a small incision, some patients we can also choose discoscopy, from the back to cut a slightly larger incision than the foraminoscope, there is also minimally invasive transforaminal approach lumbar interbody fusion (MIS-TLIF) technology is also minimally invasive surgery, the same patient postoperative The recovery time is very short, and the patient can get out of bed in 2-3 days after surgery. 3.Does the surgery hurt? The intervertebral foraminoscopy technique is done under local anesthesia, which is why it is less costly and has a faster recovery. A skilled surgeon will not cause unbearable pain during the whole procedure because he knows at which points the patient may experience pain and has already administered the anesthetic in advance, and it is normal for the surgical site to be slightly sore and swollen, and the patient is always awake during the operation and can communicate with the surgeon at any time. 4.I heard that lumbar surgery can be paralyzing, is it true? This is a good question, there are a lot of patients blackmail, just like some people say that sitting on a civilian plane will fall from the sky, nowadays most of the spine surgery is mature surgery, whether it is cervical, thoracic or lumbar spine, there are tens of thousands of spine surgery every year, the probability of doing real paralysis is as minimal as a civilian plane falling from the sky, not to mention minimally invasive surgery. Although surgery is risky, the chances of it happening are just like winning the lottery when we buy a ticket. The whole procedure is carried out under local anesthesia, and if the patient is uncomfortable at any time, the doctor will make adjustments according to the specific situation, so the whole process is safe. 5.Is it impossible to move for a long time after the surgery? The charm of minimally invasive surgery lies in minimizing the damage to the patient based on the solution of the problem. Generally speaking, you can rest in bed on the day after the surgery, and you can get off the ground on the second day and be discharged from the hospital on the third day. Isn’t it fast? 6. Will there be any recurrence after the surgery? This is also a very good question. Medicine is a science, no regular hospital doctor will pat his chest and swear to guarantee that there is no problem, why? Because it is not in line with the normal evolution of the disease, and advertisements that cure all diseases, cure all diseases, and never relapse will only appear on telephone poles. Any kind of disc nucleus pulposus removal (whether minimally invasive or conventional surgery) has the possibility of postoperative recurrence, but as long as the doctor’s instructions are strictly followed after surgery and more attention is paid to it in future work life, the recurrence rate of disc herniation can be reduced to a minimum (less than 3%). 7.What are the factors that affect recurrence after surgery? The recurrence rate after foraminotomy is about 2%-5%, and the reasons for recurrence are mainly related to age, degeneration of the disc, and postoperative lifestyle. Some people have abnormalities in their own lumbar spine structure, such as poor stability or disc texture, which can increase the chance of recurrence; in addition, good lifestyle habits should be developed after surgery, as strenuous physical activity, bending, weight bearing, and heavy lifting can increase the risk of recurrence. Generally, the intervertebral disc will slowly recover within three months after surgery, which is the peak period of recurrence, and the chance of recurrence is smaller after three months, but there is still a possibility of recurrence if you don’t pay attention to protection and keep sitting and bending. Since the foraminoscopic surgery is less traumatic, the tissue scar is less, so you can still choose to do foraminoscopic surgery after recurrence. 8.I am over 80 years old, can I still have surgery at such an old age? However, the key factor to determine the risk of surgery is not the patient’s age, but the patient’s cardiopulmonary function. Simply put, if a patient is younger than 60 years old but his cardiopulmonary function is worse than that of an 80-year-old patient, the risk of surgery is definitely greater than that of an 80-year-old patient. Pre-operative cardiopulmonary related tests will be done (such as ECG, chest X-ray, pulmonary function, etc.) The surgeon and anesthesiologist will perform a surgical evaluation and decide whether the surgery is appropriate based on the results of the evaluation. If the evaluation results are tolerable, the final decision is still up to you, and you need to understand what is affecting your quality of life? What kind of pain are you experiencing? What impact will this have on your daily life if you do not have surgery? 9.What do I need to pay attention to after the surgery? Generally speaking, patients need to rest in bed on the day after surgery, and if everything is stable, they can go to the ground with a waist brace the next day. Many people will experience postural hypotension and dizziness or even fainting when they go down to the ground immediately after bed rest, so it is necessary to increase the amount of activities little by little and gradually transition to normal activities. Avoid bending and sitting for 3 weeks after surgery, because soft tissue healing takes about 3 weeks, sitting and bending will increase the weight of the waist to affect the healing, we should adopt the principle of rather standing, lying than sitting, while turning in bed to avoid excessive twisting of the waist (twisting twist-like). 10.Do I need aids when walking? Patients are not restricted to walk after surgery and do not need any auxiliary tools. However, during the first month after surgery, you can wear a lumbar support when walking (remove it when lying down), so that the disc can recover quickly in a relatively safe environment and reduce the risk of recurrence. 11.What should I pay attention to in my daily life such as going to work? There are no special restrictions on daily life after surgery, mainly avoiding sedentary and bending weight for three months, and office workers should get up and move for ten minutes every 30-40 minutes of sitting and avoid driving for a long time. There is no restriction on activities after surgery, instead, patients are advised to move around appropriately. You can swim and other sports, but you should avoid sports with large weight on the waist, such as lifting barbells, etc. 12.What should I pay attention to after discharge from the hospital? Once you have a herniated disc, it means that the disc has been severely degenerated, and even if you choose surgery, if you don’t pay attention to it in general, it will increase the risk of recurrence. The old saying “three parts treatment, seven parts maintenance” is true. There is no surgery that can restore a degenerated disc to its original state, just as it is difficult to reunite a mirror. Therefore, it is necessary to follow medical advice after surgery and pay attention to the daily life. Many patients do not completely disappear after surgery and hope that functional exercise can relieve them, which is not right. Functional exercise can only strengthen the muscles of the lower back and lower limbs and relieve the symptoms of postoperative limb weakness, but it does not work on nerve damage symptoms such as numbness. To alleviate numbness, one can only rely on one’s own recovery and medication assistance. Generally, in the three months after surgery, patients can do exercises such as five-point support or small swallow fly (as shown in the figure) to strengthen the strength of the lumbar back muscles, increase the stability of the lumbar spine, delay the aging of the intervertebral disc and reduce the chance of recurrence. Insist on practicing 2~3 times a day for 10 minutes each time.