Causes I. Degenerative changes: At present, it is believed that the basic cause of the disease is degenerative changes of lumbar intervertebral discs. Degenerative change is the objective law of all biological life, growth, decline and death. Due to the special physiological function of the lumbar spine, the degenerative change of lumbar intervertebral discs is earlier than that of other tissues and organs, and the progress is relatively fast. This process is a long-term, complex process. The so-called lumbar degenerative disc changes: that is, due to the compression of the intervertebral discs by the weight, coupled with the lumbar region is often bent, backward extension and other activities, easy to cause intervertebral discs of the extrusion and wear and tear, especially the lower lumbar region of the intervertebral discs, thus producing degenerative changes. Degenerative changes in the lumbar intervertebral discs are the basis of this disease. Second, other factors: 1, external forces: in daily life and work, some people tend to have long-term lumbar force improper, excessive force posture or incorrect position. For example, long-term stooping work of coal miners and construction workers often need to bend down to lift heavy objects. These long-term repeated external damage caused by the cumulative effect on the intervertebral disc, aggravating the degree of degeneration. 2. The weakness of the intervertebral disc’s own anatomical factors: (1) The intervertebral disc gradually lacks blood circulation after adulthood, and its repair ability is poor, especially after degeneration, and its repair ability is even weaker. (2) The fibrous annulus of the posterior lateral aspect of the intervertebral disc is relatively weak, and the width of the posterior longitudinal ligament decreases significantly at the lumbar 5 and sacral 1 planes, which significantly weakens the strengthening effect on the fibrous annulus. (3) Lumbosacral segment congenital anomalies: lumbosacral segment malformations can increase the incidence of these anomalies cause the width of the intervertebral space is not equal, and often cause the joints protruding, the joints are subjected to more rotational strain, so that the annulus fibrosus is subjected to varying pressures, accelerating degeneration. 3, race, genetic factors: people of color have a lower incidence rate, such as Indians and black Africans, etc. The incidence rate is significantly lower than other ethnic groups. Pathology of lumbar disc herniation can be roughly divided into three stages: 1, pre-herniation: the nucleus pulposus can become fragmented due to degeneration and injury, or scar-like connective tissue, and the degenerated fibrous ring can be thinned and softened due to repeated injuries or produce fissures. In this stage, patients may have lumbar discomfort or pain, but there is no radiating lower extremity pain. There are also people who have no original lesions, can be caused by a large violence caused by the protrusion of the nucleus pulposus. 2, herniation: trauma or normal activities increase the pressure of the disc, the nucleus pulposus protrudes from the weak or ruptured annulus fibrosus. The herniated material stimulates or presses the nerve root, which causes radiating lower limb pain, or presses the cauda equina nerve, which causes dysfunction of urination and defecation. In elderly patients, due to disc degeneration, the entire annulus fibrosus becomes weak and loose, and the disc may diffusely bulge out to the surrounding area. Late stage of herniation: After lumbar disc herniation, if the disease duration is long, various secondary pathological changes may occur in the disc itself and other neighboring structures. The basic factor of lumbar disc herniation is the degeneration of intervertebral discs, but some triggering factors can increase the pressure in the intervertebral space and cause the nucleus pulposus to protrude. Such predisposing factors are often related to the following factors: 1. Age factor: the most common age of lumbar disc herniation is 30-50 years old, and the average age of surgery is 40 years old, so degeneration may be an important factor. 2. 2.Height and gender: it is believed that too tall stature will also be prone to lumbar herniation, and the incidence rate of men is 5 times that of women. 3, increase abdominal pressure: clinically about 1/3 of the patients before the onset of a clear increase in abdominal pressure factors, such as violent coughing, sneezing, breath holding, straining to defecate. So that the abdominal pressure increases, destroying the equilibrium state between the vertebral joints and the spinal canal. 4, poor posture: people in the completion of a variety of work, the need to constantly change a variety of positions to relieve lumbar pressure, such as long-term in a position unchanged, can lead to localized cumulative injury. Especially in the long-term bad posture is more likely to induce the disease. 5, occupational factors: the highest incidence of heavy manual labor, white-collar workers the lowest. Automobile drivers, due to long-term bumps and vibration, the pressure on the intervertebral discs is large and repeated changes, also easy to induce disc herniation. 6, cold and damp: cold or damp can cause small blood vessel contraction, muscle spasm, so that the pressure of the intervertebral disc increases, which may cause degeneration of the intervertebral disc rupture.