1. Do all lumbar disc herniations require surgery? Lumbar disc degeneration is a normal part of the aging process, just like wrinkles in the skin. If it does not cause symptoms, no treatment is needed. Conservative treatment is preferred for lumbar disc herniation. Conservative treatment includes bed rest, medication, traction, and physical therapy. Surgery should be considered only if the strict conservative treatment is ineffective and seriously affects work and life. 2, lumbar disc herniation surgery choice of minimally invasive treatment or fusion treatment? What surgical methods are used after the failure of formal conservative treatment? Generally speaking, the structure of the human body is the original good, so the human body structure problems need to choose the treatment method that minimizes the impact on the original normal structure. For example, if a decayed tooth can be filled, it should not be extracted and fitted with a denture. So for open fusion treatment and minimally invasive treatment can achieve satisfactory results, give priority to minimally invasive treatment. 3.Will lumbar disc herniation recur after surgery? Patients often ask: Will the herniated disc recur after surgery? Is minimally invasive surgery a “radical” surgery? To answer these questions, it is important to recognize that the lumbar disc is a normal structure in the human body and has an important function: to cushion pressure and maintain mobility in the lumbar spine. Therefore, if the disc is completely removed, the function of the lumbar spine is partially lost. Fusion surgery requires complete removal of the disc, and the problems associated with this are obvious. It is important to use minimally invasive methods to remove the portion of the disc that is causing the disease, preserve the remaining normal disc tissue, relieve symptoms, and preserve the function of the lumbar spine. Just like a decayed tooth, it’s important to fill it when it’s broken, then fill it again when it’s broken, and pull it out only when it’s really bad. Although herniation may still occur after minimally invasive treatment for lumbar disc herniation, do not worry because it is not a malignant tumor. Moreover, the reopening rate of minimally invasive surgery and fusion surgery will not be too different when experienced professionals deal with lumbar disc herniation. 4.What are the minimally invasive surgeries for lumbar disc herniation? 1, Percutaneous Endoscopic Lumbar Intervertebral Disc Removal (PELD); 2, Microscope-assisted Lumbar Intervertebral Disc Removal (MILDRED) under the passageway, PELD is an endoscopic surgery, which is performed under the endoscope, and the disc and its surrounding tissues are clearly observed through the magnified video, so as to complete the removal of the disease-causing discs. Microscope-assisted lumbar disc removal is performed under a special tube with the aid of a microscope, and the diseased disc is removed under direct vision. The incision for the former is relatively small, less than 1cm. 5. What are the advantages of percutaneous endoscopic lumbar disc removal (PELD)? PELD is the minimally invasive treatment of choice for lumbar disc herniation. When this is difficult due to anatomical anomalies, a subaccessory microscope-assisted lumbar disc removal can be used, which is slightly more invasive. The advantages of PELD are obvious: (1) local anesthesia, quick recovery, intraoperative communication with the patient to prevent nerve damage. (2) The incision is small, about 7mm, although the incision is small, the internal tissue structure can be seen clearly through the endoscope, just like gastroscopy, the doctor can see the internal structure of the stomach without drilling into the stomach. This kind of surgery does not need to bite the bone, do not cut the ligamentum flavum, so there is little damage to normal tissue. (3) There is little bleeding and PELD patients do not need blood transfusion therapy. The amount of bleeding is like the amount of blood drawn once during a physical examination. (4) Antibiotics are not needed after surgery. Reduces the problem of antibiotic resistance and reduces drug side effects. (5) Short hospitalization: you can get down to the floor 4 hours after the surgery and can be discharged the next day. (6) Low cost, less expensive than open fusion surgery as no internal fixation material needs to be implanted. (7) Non-ultimate surgery, preserving lumbar spine motor function. 6. Is radiofrequency ablation surgery a more minimally invasive procedure for lumbar disc herniation? Radiofrequency ablation surgery belongs to interventional therapy, which also includes ozone, collagenase, laser and so on. They are characterized by the fact that they are performed blindly without cutting the skin and through puncture, so they are not really surgical procedures and are only suitable for patients with mild conditions. 7. What is the reason for the reappearance of symptoms after minimally invasive surgery for lumbar disc herniation? The reappearance of symptoms after the disappearance of early symptoms may be due to the edema reaction of the nerves. Generally speaking, after the surgery, we should pay attention to rest and protect the lumbar vertebrae, and the reappearance of symptoms will gradually disappear. However, if symptoms appear in the distant future, the cause of the symptoms should be analyzed. If it is sciatica, it is necessary to check whether the lumbar disc has herniated again and in which part of the spine it has herniated. If it is just low back pain, it may be a degenerative condition such as lumbar instability, so you don’t need to worry too much about it. You can strengthen your low back muscle training, and we have a very good rehabilitation team that can guide you in the exercise.