Lumbar disc herniation in adolescents is not uncommon clinically. Some statistics show that its incidence accounts for about 1% of all lumbar disc herniations. The pathogenic factors are relatively simple, mostly due to trauma. There is no consensus on how to choose the treatment method. The authors treated 21 cases of lumbar disc herniation in adolescents from 1994 to 1999 by non-surgical treatment and observed the follow-up for 4 years, and the treatment methods and efficacy are reported as follows: Clinical data General data 15 males and 6 females among 21 cases; age 12 ~ 20 years, average 16.8 years; duration of disease 7 days to 1 year and 2 months, average 10.2 months; occupation Students 12, 4 athletes, 4 farmers, 1 soldier; all had a clear history of trauma or sprain before onset. Clinical manifestations Low back pain with radiating pain of one lower limb in 15 cases, with bilateral radiating pain in 4 cases; obvious lumbar scoliosis in 12 cases; lumbar back muscle tension in 8 cases; positive straight leg raising test in 19 cases; decreased thumb and back extension in 9 cases; abnormal skin sensation in the dominant area in 8 cases; abnormal tendon reflex in 7 cases. All cases were diagnosed by X-ray plain film and CT examination of the lumbar spine, and CT showed disc herniation in the corresponding intervertebral space plane. Among them, 1 case was L3-4, 11 cases were L4-5, 9 cases were L5-S1; 18 cases were lateral-posterior herniation, and 3 cases were central type herniation. Treatment method Lumbar spine traction group (1 group) computer-controlled lumbar spine traction bed, supine position, continuous horizontal traction, mass of 1/2 to 2/3 of the patient’s body weight, 25 min each time, 15 times for a course of treatment. Epidural injection group (group 2), using the sacral canal or lumbar epidural injection method, the injection drug is prednisolone 62.5mg or Coninectone 20mg, 2% lidocaine 2.5ml, diluted to 10-20ml with saline, once a week, 3 times for a course of treatment. Patients in this group were still given lumbar traction during the injection period in the same way as group 1. Percutaneous puncture group (group 3): operated under DSA or CT monitoring, with the patient in lateral recumbency and 6-8M from the posterior midline on the horizontal line of the diseased vertebra as the entry point. The nucleus pulposus was cut and aspirated using a domestic APD-III automatic nucleus pulposus spinner for 5-10 min, and the nucleus pulposus was cut and aspirated at about 1-4 g. The needle entry point for collagenase injection was the same as above, and after the puncture needle entered the diseased disc, 1,200 units of domestic injectable collagenase and 5 ml of saline were used to extract 1 – 2 ml of collagenase into the nucleus pulposus. -The needle tip was then retreated to the epidural space of the intervertebral foramen on the lesion side, and 3 ml of collagenase was injected after the injection of contrast agent to confirm the location of the needle tip. Results Efficacy criteria: NaKai efficacy assessment criteria were used [2]. Excellent: all the symptoms and features disappeared and the original work was resumed. Good: symptoms and signs basically disappeared, with occasional back and leg pain after exertion, and resumed original work. Possible: symptoms and signs improved, still had mild back and leg pain, unable to perform normal work. Poor: no improvement or aggravation of symptoms and signs, unable to perform normal work. Efficacy results: recent efficacy (within 15 days and 30 days) of the lumbar traction group (group 1) was 42.8% and 57.1%, respectively; epidural injection group (group 2) was 62.5% and 75.0%, respectively, and percutaneous puncture group (group 3) was 66.6% and 83.3%, respectively (Table 1), and the excellent rate of group 3 and group 2 was higher than that of group 1, but there was no statistical difference. The long-term efficacy, excellent maintenance time and recurrence rate were not different among the three groups.