Lumbar disc herniation, the full medical name should be “lumbar disc herniation”, according to the degree of herniation can be divided into: 1, disc bulging (bulging): the most minor. The annulus fibrosus of the intervertebral disc uniformly exceeds the range of the intervertebral space, and the intervertebral disc tissue is not limited to protrusion. 2.Herniated disc (protruded): moderate. The intervertebral disc tissue is displaced beyond the intervertebral space in a restricted manner. The displaced intervertebral disc tissue is still connected to the original intervertebral disc tissue, and the diameter of its basal continuous part is larger than the displaced intervertebral disc part beyond the intervertebral space. Zhang Yuanjun, Intervertebral Disc Department, Linyi No.4 People’s Hospital, Linyi, China.3. Extruded intervertebral disc is severe. The diameter of the displaced intervertebral disc tissue is larger than the basal continuum and is displaced beyond the intervertebral space. The prolapsed disc tissue mass is larger than the ruptured intervertebral disc space and is located within the spinal canal through this fissure. Clinical manifestations (1) Low back pain Most patients have a history of low back pain for weeks or months, or a history of recurrent low back pain episodes. The degree of lumbar pain varies in severity, and in severe cases, it may affect turning over and sitting up. Generally, the symptoms are reduced after resting, coughing, sneezing or straining during bowel movements can aggravate the pain. (2) Lower extremity radiating pain on one side of the lower extremity sciatic nerve area radiating pain is the main symptom of this disease, often in the disappearance of low back pain or reduce the appearance. The pain starts from the buttocks and gradually radiates to the back of the thigh, the outside of the calf, and in some cases to the outside of the dorsum of the foot, the heel or the ball of the foot, affecting standing and walking. If the protrusion is in the center, it is in the cauda equina symptoms, bilateral protrusion, the radiation may be bilateral or alternating. (3) Lumbar movement disorders Lumbar movement is affected in all aspects, especially in posterior extension disorders. In a few patients, forward flexion is obviously limited. (4) Scoliosis Most patients have varying degrees of lumbar scoliosis. The direction of scoliosis can indicate the location of the protrusion and the relationship between the nerve roots. (5) Numbness of the lower limbs Those with a long course of the disease often have subjective numbness. It is mostly limited to the posterior-lateral calf, dorsum of the foot, heel, or sole of the foot. (6) Temperature drop of the affected limb, many patients feel cold in the affected limb, objective examination, the temperature of the affected limb is lower than the healthy side; some dorsal foot arterial pulsation is also weaker, which is due to sympathetic nerve stimulation. This is due to sympathetic nerve stimulation. It must be differentiated from embolic arteritis. The main cause of lumbar disc herniation has internal and external causes, the main internal cause is degenerative changes in the lumbar spine; external causes include trauma, strain or overwork, cold and dampness, etc. In addition, it is related to age, height, genetics and other factors. In addition to age, height, genetics, pregnancy, smoking: diabetes and other common triggering factors ① increased abdominal pressure, such as coughing, constipation, defecation and so on. ② improper lumbar posture, when the waist is in a flexed position, if suddenly rotated, it is easy to induce herniation of the nucleus pulposus. ③ Sudden weight bearing, in the absence of adequate preparation, sudden increase in the lumbar load, easy to cause herniation of the nucleus pulposus. Trauma to the lumbar region, acute trauma can affect the fibrous ring, cartilage plate and other structures, and promote the degeneration of the herniated nucleus pulposus. Occupational factors, such as long-term driving, sedentary people, easy to induce disc herniation. Auxiliary examination should be done by taking front and side view film of lumbosacral spine. When there is difficulty in diagnosis, special examinations such as CT scan and magnetic resonance may be considered to clarify the diagnosis and herniated part. Patients with no obvious abnormality in the above examinations are not completely excluded from lumbar disc herniation. Lumbar intervertebral disc herniation should be distinguished from the following diseases: 1. Intermittent claudication is the most prominent symptom of lumbar spinal stenosis. Patients complain that after walking for a certain distance, their lower limbs are aching, numbness and weakness, and they have to squat down to take a rest before they can continue walking. Cycling can be asymptomatic. 2, lumbar isthmus fissure slip 3, lumbar spine tuberculosis 4, lumbar spine tumor 5, lumbar spine intravertebral canal tumor Conservative treatment: bed rest as the main conservative treatment method, other conservative methods include drug therapy, physical therapy, acupuncture. 1, non-steroidal analgesics such as anti-inflammatory pain, ibuprofen, etc., analgesic effect is strong, anti-inflammatory and anti-rheumatic effect is also strong. However, generally anti-inflammatory analgesic drugs can not be taken for a long time, especially for patients who also suffer from liver/kidney disease, hypertension, diabetes should pay more attention to the contraindication, so as not to cause new discomfort. 2.Central muscle relaxants: such as Myrna. 3.Neurotrophic drugs: e.g. Microprobe, etc. 4.Chinese medicine, ointment 5.Physiotherapy:such as massage, hot compress, cupping, etc. 6.Traction therapy 7.Surgery Surgery: Patients with simple lumbar disc herniation can receive minimally invasive endoscopic disc surgery in our hospital, which is small in incision, traumatization, fast in recovery, and can be down to the ground at an early stage.