In daily practice, we encounter many patients with herniated discs combined with calcification, which is a special type of disc herniation. This is a special type of disc herniation. It is a calcification of the herniated disc tissue, or a combination of calcification of the posterior longitudinal ligament together. It resembles a type of bone spur and is most often seen in the lumbar spine, but can also occur in the cervical and thoracic spine. This type of disease has the following characteristics: the patient is young, the disease has a long duration, the disease is often recurrent, the symptoms are severe, the lumbar region has mostly been traumatized, and long-term conservative treatment. Calcified intervertebral disc tissue causes a reduction in the space for accommodating nerves in the spinal canal or close adhesions with the dura mater (the outermost membrane wrapped around the cauda equina) and nerve roots, compressing the surrounding nerve roots, mostly causing more pronounced symptoms such as pain in one leg, numbness, intermittent claudication (pain after walking a certain distance, quickly relieved after rest, and not present when cycling), and central type herniated calcification causes symptoms in both legs. Why does calcification occur? The cause of intervertebral disc calcification is still unclear and is currently thought to be related to the degeneration of the disc (like an elderly person growing gray hair) and certain unknown factors (trauma, infection, etc.). The mechanism of its occurrence may be the loss of normal nutrient supply to the protruding disc tissue after disc herniation, resulting in water loss from the protruding tissue and sclerosis. At the same time, dysfunction of the endocrine system (such as metabolic disorders, hypervitaminosis D, hemolytic anemia) may also cause the deposition of calcium salts in the intervertebral disc, gradually forming calcification. What is the difference between calcified and normal disc herniation? Since calcified disc herniation is a special type of disc herniation, its symptoms are similar to those of ordinary disc herniation, and can have no symptoms, but also numbness, pain, intermittent claudication, and inability to control urination and defecation in one or both legs to varying degrees; however, patients with calcification are more serious, and most patients have more stubborn pain, which is not easily relieved by conservative treatment; X-ray examination is of limited help in X-rays are of limited help in the diagnosis of the disease, while CT examinations can detect the majority of patients, and CT examinations can often clearly show the location, size, shape and nerve compression of the calcified disc, which is helpful for doctors to determine the severity of the disease. What are the risks of calcification? What are the potential difficulties in treating the disease? The surface of the calcified disc tissue is mostly uneven, and the calcified tissue is hard and inelastic, so when it compresses the nerve, there is no room for cushioning, causing snagging and friction on the nerve, and the damage is more obvious. At the same time, the calcified disc tissue is often closely adhered to the nerve and other surrounding tissues, which not only aggravates the symptoms, but also increases the difficulty of removing the diseased tissue during surgery, and some of the severely adhered calcifications. They cannot be removed because they cannot be separated from the normal tissue and have to remain in the body. This has an impact on the patient’s recovery after surgery, and the treatment effect after surgery is not as good as that for patients with general disc herniation. How to choose the treatment and timing of surgery? Patients with calcified disc herniation with less severe symptoms can be treated conservatively (absolute bed rest and traction therapy). However, since the herniated disc tissue has degenerated, lost moisture and elasticity, and become calcified, and is often closely adhered to the surrounding tissue, the possibility of the herniated and calcified part of the disc returning to the normal site is very small, so the compression on the nerve is more severe than that of the non-calcified herniation. The efficacy of conservative treatment is mostly limited to a short period of time, about six weeks. This is because it is currently believed that long-term conservative treatment is likely to be one of the causes of calcification of the herniated disc; and the fact that calcification is already present in the patient indicates the presence of high-risk factors for calcification in this group of patients. If conservative treatment is continued, for the two reasons mentioned above, there is a greater likelihood that calcification will continue to worsen in such patients, making it easy for the condition to continue to worsen. For patients with calcified disc herniation whose symptoms are severe and have already affected their daily life, because the calcified disc tissue is severely compressing the nerves and widely adhering to the nerves and other surrounding normal tissues, too long conservative time aggravates the friction or compression of the calcified material on the nerves and further aggravates the nerve damage, so it is not advisable to overemphasize the time of conservative treatment and surgery can be performed earlier. What circumstances require surgical treatment? 1.Normative conservative treatment (absolute bed rest, traction treatment) is ineffective for 3 months. 2.Acute attack of severe back and leg pain, which cannot be relieved by conservative treatment and seriously affects life and sleep. 3. Clinical manifestations of nerve root or cauda equina nerve palsy appear, the more common manifestation is paralytic foot drop and urination cannot be controlled by oneself. If these conditions occur, you should seek medical attention and undergo surgery as soon as possible. Minimally invasive surgery? Or traditional open surgery? The current treatment methods for calcified disc herniation can be broadly divided into traditional open surgery and minimally invasive surgery. Traditional open surgery has mature surgical techniques, but has disadvantages such as greater trauma, more bleeding, higher surgical costs, and longer hospital stays. Minimally invasive surgery has the advantages of less injury, less bleeding, shorter operation time, lower medical costs and shorter hospital stay, but has the disadvantages of high surgical technique requirements, small range of applicable patients and difficulty in removing calcified tissues. Some foreign scholars also believe that herniated disc tissue with calcification does not need to be removed because it is already stable, as long as the posterior window is opened to decompress and increase the space for nerve roots. Therefore, when choosing a surgical procedure, patients should listen to the advice of a professional doctor and choose a surgical procedure suitable for their condition to achieve the best treatment effect; instead of blindly pursuing the so-called minimally invasive techniques advertised by the media, they will miss the best treatment effect. What are the daily precautions for patients with calcaneal type and how to protect the spine? In daily life, attention should be paid to less bending, lifting heavy objects, avoiding heavy physical labor, paying attention to sitting posture, avoiding sitting or standing with the body leaning forward, avoiding prolonged sitting and standing, and sleeping on a hard Simmons or hard bed as much as possible. For patients with cervical spondylosis accompanied by cervical disc calcification, avoid keeping the same action for a long time without moving the neck. Especially for office workers, the computer screen should not be too low, and should not play with the cell phone or palmtop for a long time, so that the cervical vertebrae are under load for a long time, which can easily lead to cervical lesions. Strengthen the neck and lumbar back muscle exercise. When the disease can be properly worn lumbar circumference, to share the force of the spine, to relieve the condition, 3 to 6 weeks can be, not long-term wear, otherwise may be dependent on the protective gear, resulting in muscle atrophy, but aggravate the condition of lumbago.