In general, it mainly includes: early lumbar support and protection, nerve root adhesion prevention training, functional exercises for the muscles of the low back, functional exercises for the muscles of the lower limbs and prevention of recurrence and re-protrusion. Finally, we will talk about 2 details, one is the postoperative medication change and the other is why there are fluctuations in postoperative symptoms. First, 4-6 weeks of rest is recommended after minimally invasive lumbar spine surgery A relatively strict bed rest for 2 weeks. Then a small range of activities for 4 weeks. The general work intensity can go to work 4 weeks after surgery. Drivers, teachers, ticket takers, chefs, etc. need 6 weeks to go to work. Although the lumbar foraminoscopy did not destroy the lumbar structures, the original fibrous ring fracture caused by the herniation was still present after the herniated nucleus pulposus was removed. Previously, when I was in college, the textbook said that the fibular ring was weakly healing and would not heal. After my clinical practice, I believe that the non-healing is often caused by the cantonal nucleus pulposus, and if the herniated nucleus pulposus is removed cleanly with minimal invasion, the fibrous ring can still heal in about 6 weeks. I want patients to rest for 4-6 weeks after surgery. This will greatly reduce the possibility of recurrence. After 4-6 weeks, the range of motion and the amount of activity should be increased gradually, and the amount and range of activity of getting out of bed can be increased gradually with time and functional exercise of the muscles of the low back. Although some patients do not have intervertebral disc compression nerve after surgery, the hip waist and leg comfortable, feel very good, very beautiful and excited, or remind not to get carried away, to rest well. Well done surgery, doctors, patients, family members and friends have paid a lot, it is not easy, to preserve the revolutionary war results, as far as possible to reduce recurrence. Second, 8-12 weeks of postoperative waist circumference protection Must not wear a waist circumference when lying in bed, but when getting out of bed and moving around, must wear a waist circumference before getting out of bed. The role of the waist circumference is to reduce the force on the spine by 25%, that is, 1/4 of the force is not transmitted to the pelvis through the waist, but through the waist circumference. Use the lumbar girth to protect the support protection well for 8-12 weeks, after this period, the chance of recurrence is greatly reduced. Third, early nerve root prevention adhesions and lower limb muscle strength training After open surgery, adhesions within the spinal canal and nerve root canal are still inevitable, and severe intra-vertebral adhesions can even cause serious symptoms. One of the outstanding features of minimally invasive lumbar spinal foraminoplasty is that adhesions are very mild. However, I still want to tell you that early straight leg raising training after minimally invasive surgery is a good way to prevent nerve root adhesions and is also one of the methods of lower extremity muscle strength training. Generally, straight leg raising training can be started in bed the day after surgery, and the training is performed 3-4 times a day, with 10 straight leg raises each time, alternating legs. This independent straight leg raising training should be continued for 2 weeks, especially in the early 1-2 weeks after the surgery is very important. Low back muscle function training Low back muscle function training is one of the main methods to improve the lumbar support function, not only can quickly restore the strength of the lumbar region, but also is the main means to prevent and treat postoperative low back pain, commonly used methods of low back muscle exercise include “small swallow fly” and abdominal lift hip training, low back muscle exercise Generally after 4 weeks after surgery, 2 times a day, one for 2 seconds each time, 30 for one time. 5-10 minutes, encourage lifelong perseverance to keep the muscles of the low back strong. What is the best exercise after lumbar minimally invasive surgery? A good exercise method after lumbar minimally invasive surgery can not only exercise all parts of the body, but also will not cause other tissue side damage, and swimming is a very good way to exercise, swimming is almost a “light advantage not to lose” exercise. We orthopedic surgeons love this sport so much that we would like to recommend breaststroke exercise to everyone. Therefore, the best exercise for post-operative lumbar spine is swimming. In general, swimming can be started 12 weeks after surgery. Sixth, prevention of recurrence of disc herniation after minimally invasive intervertebral foraminal surgery After minimally invasive surgery, the recurrence rate is why 2.7-4.7%. How to prevent it? That is to reduce the triggering factors that lead to re-protrusion, that is, to minimize bending movements, especially strenuous bending movements, and to minimize activities such as bending to lift or carry heavy objects, while minimizing twisting movements and sports. One of my patients had a herniated disc because of allergic rhinitis, after three violent sneezes, theoretically there is a danger of violent coughing and sneezing. There is a danger of movement when going to the toilet, so be careful and pay attention to it. VII. About postoperative medication change Because the postoperative wound is very small after minimally invasive surgery, usually only 0.6-0.7 cm in size, so it is easy to change medication after surgery. Because we use cosmetic sutures, there is generally no need to remove the sutures. 2-3 days is enough for a medication change. The hospital dressing is removed, then disinfected with alcohol or iodine, and then glued on with a sterile dressing (available at pharmacies). Generally 10 days will fall off naturally. Then you can leave it alone. 10 days after surgery, you can take a shower. Eight, explain why there are fluctuations in symptoms after surgery Whether minimally invasive or open surgery, after surgery, there are fluctuations in symptoms. Since everyone has them, they become part of the pattern, so there is no need to panic. These fluctuations are usually like the rise of a “stock” and stabilize in about 3 months. In some cases, it can take a little longer. The fluctuations are as follows: 1) pain before surgery, and then similar pain after 4-7 days after surgery. This is due to nerve edema and usually goes away in 9-10 days. If heavy, take some Mai Zhi Ling, it will also gradually get better. 2) 1 month after surgery, some patients will have back discomfort, or vague pain in the legs and hips, which is related to post-operative activities, generally rest for a while, or adjust the amount of exercise, or the weather improves, hot compresses, etc. will get better. 3) 2-3 months after surgery, back discomfort, related to poor back strength, back muscle exercise can improve. 4) After surgery For a certain period of time, leg pain on the same or opposite side appears again, perhaps related to adhesions, but generally there is no major problem and it can be improved gradually. Although it is said that the fluctuation of postoperative symptoms has an impact on the patient’s psychology and causes panic, the consequences are generally not too great, and most patients are stable for 3-6 months after surgery without much main description.