First, is the back and leg pain caused by a herniated disc compressing the nerve? Answer: It is easy to see through the four reasons we asked rhetorically that the pain is not caused by the compression of the sciatic nerve by the intervertebral disc, so what are the causes of lumbar and leg pain in patients? According to our clinical experience of treating patients with lumbar synostosis for more than ten years, the cause of lumbar pain in lumbar synostosis is mainly aseptic inflammation, which is located in the nucleus pulposus of the intervertebral disc. The normal intervertebral disc has a peripheral fibrous ring and a central nucleus pulposus, the tissue structure is like a flattened egg, the white is like the fibrous ring and the yolk is like the nucleus pulposus; when the white (fibrous ring) ruptures, the yolk (various chemical substances of the nucleus pulposus) overflows and infiltrates the sciatic nerve behind the intervertebral disc, resulting in back and leg pain. So the back and leg pain from lumbar synostosis is a sterile inflammation! Second, the more expensive the treatment, the better the treatment effect? A: The answer is no! For patients with lumbar synostosis, the treatment plan should be simple to complex, with various inexpensive conservative treatments first, then moderately priced interventional treatments, and only when the treatments are ineffective, finally surgical treatments of tens of thousands of dollars. The second of the ten misconceptions about lumbar synostosis; the intervertebral disc itself has a function!!! Third, do the intervertebral discs themselves have a function? A: The answer is yes!!! The spine is the backbone of the human body and consists of several vertebrae (7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4-5 caudal), and the intervertebral discs are located between each vertebra (except the sacrococcygeal). The function of the intervertebral discs is similar to the shock absorbers of cars and motorcycles. After waking up in the morning, the intervertebral discs are in working condition, the spine is under stress, especially when a person is sitting, squatting, bending, running and jumping when the spine is under stress, the intervertebral discs are responsible for the conduction of these forces, dispersed out, when the intervertebral discs are damaged, the function is also reduced, as if a person, who could have carried 150 pounds on his shoulder, can only pick 70-80 pounds. So, don’t go easy on the discs! Before doing any interventional minimally invasive treatment ask first; will this treatment destroy your discs? Four of the top ten misconceptions about lumbar synostosis explained; the discs have self-repairing functions!!! Fourth, does the intervertebral disc have a self-repairing function? A: The intervertebral discs are self-repairing! This is currently ignored by the vast majority of people, and even professional doctors, which causes deviations in the direction of treatment, resulting in unnecessary pain and trauma to patients. We all know: after stomach surgery, gallbladder surgery, rupture surgery, the surgeon just a few stitches on the skin, daily change of medication, the body will start the self-repair mechanism, new blood vessels, fibrosis, scar formation at the surgical incision, the surgical incision will produce will heal. The reason is the same after the rupture of the intervertebral disc’s fibrous ring. V. Do patients care only about the herniated disc during treatment? A: The vast majority of patients, before treatment, are concerned about whether the protruding disc will shrink back after treatment. In fact, it is the patient after the disc surgery, the clinical symptoms disappeared, cured, postoperative CT, MR examination, the protruding disc is still protruding, then why the clinical symptoms disappeared? It is because the surgery produces bleeding, fibrosis, and scarring to close the ruptured annulus fibrosus. Our CT-guided drug interventions, which apply drugs directly to the surface of the ruptured annulus fibrosus, also play a role in helping to repair it. So, with the clinical symptoms gone, there is no need to drill the bull’s-eye of what to do if the disc is still herniated!!! A: The vast majority of patients with lumbar herniation ask their doctors during treatment, “Will my herniated discs go back after intervention?” , it is important to know that the root cause of lumbar pain is the rupture of the intervertebral disc’s annulus fibrosus and the spillage or leakage of chemical substances from the nucleus pulposus, causing chemical inflammation of the lumbar and sciatic nerves. So; to have the pain eliminated, the fibrous annulus of the intervertebral disc closes on it, protrusion or not is not the point!!! We have also had patients with lumbar herniation healed for a number of years and then again had a CT of the lumbar spine and found that the herniated disc disappeared. The top ten misconceptions about lumbar synostosis treatment are explained Six: Is the treatment of lumbar synostosis only the responsibility of the doctor… VI. Is the treatment of lumbar synostosis only the responsibility of the doctor? A: During the treatment of lumbar synostosis, close cooperation between patients and doctors is needed to follow the orders of professional doctors. Some patients, especially a few middle-aged women, are not used to seeing others doing housework and doing chores before their rest time arrives. Some patients, too, start to move around when their lumbar pain symptoms get better, and some like to hear hearsay and even take what non-professionals say as a treasure, resulting in aggravation of their symptoms. A ruptured fibrous ring will only heal with your cooperation! Therefore, you must cooperate with your doctor during treatment! Seventh of the ten misconceptions about lumbar herniation: when pushing, the herniated disc can be pushed back… Seven: Can a herniated disc be pushed back when pushing? A: To answer this question, you need to understand some local anatomical knowledge of the human body; the intervertebral disc is located between two vertebral bodies, there is a spinal canal behind the disc, herringbone rows of bony vertebral arch, and there are 3-4 centimeters of muscle, when pushing, the force used must pass through the above-mentioned tissue to reach the herniated disc. The herniated disc is a soft tissue, which is elastic in itself, and the herniated part will not retract even if the herniated disc is directly compressed. Therefore, we think it is impossible to push back the herniated disc! Eight of the ten misconceptions about lumbar synostosis explained: the more patients with lumbar synostosis have back and leg pain, the more they have to exercise… Eight: the more patients with lumbar synostosis have low back and leg pain the more they have to exercise? A: To know whether you can exercise, you have to understand why patients with lumbar synostosis have low back and leg pain? The intervertebral disc is composed of the fibrous ring and the nucleus pulposus, the normal intervertebral disc is a sealed compartment, the fibrous ring wraps the nucleus pulposus tightly, the nucleus pulposus contains many chemical substances, when the fibrous ring cracks, fissures, fractures in serious cases, the chemical substances contained in the nucleus pulposus overflow, or leak, there is a local chemical inflammation in the back of the disc, if it affects the sciatic nerve, also known as chemical radiculitis, the disc at this time is like a Leaky tire, the more you press, the more gas leaks, the more pain. So, you can’t exercise. Nine of the ten misconceptions about lumbar synostosis: the need for CT and MR imaging alone… Nine: Making a decision on the need for treatment just based on CT, MR imaging A: Nowadays, a lot of patients come to the hospital and just as soon as they see the physician, they take out the CT or MR film and say; “Physician, I have a herniated disc in my lumbar spine and I need interventional treatment.” There are also patients who go to the hospital and the physician does not say a word, does not ask about the medical history, picks up the CT or MR film and says: “Open up and put on a plate”. This is a big misconception, because a normal person can have a herniated lumbar disc. There are three major elements in the treatment of lumbar herniation: 1. clinical symptoms: back pain, leg pain. 2, physical examination: 3, imaging tests: lumbar spine CT, MR, X-ray plain film. The three major elements must be complete before treatment can be done. Also, imaging tests (CT, MR) check for herniated/bulging discs, but no clinical symptoms, do not do any treatment!!! Ten myths about lumbar herniation No. 10: Use multiple interventions for one disc at the same time… Ten, the use of multiple minimally invasive interventional methods for one disc at the same time? A: At present, we have a variety of interventional treatment methods in China: 1, ozone 2, collagenase 3, semiconductor laser 4, disc cutting 5, radiofrequency 6, temperature-controlled thermal therapy disc repair (IDET) and so on. Except for IDET, the mechanism of the above minimally invasive interventional treatment is the same as that of surgery; surgery is an open incision to remove the nucleus pulposus; minimally invasive interventional treatment is to heat, chemically dissolve or remove the nucleus pulposus within the disc, also known as; disc decompression, to achieve the treatment purpose of eliminating the patient’s back and leg pain. Therefore, if multiple minimally invasive interventions are used or applied multiple times to an intervertebral disc to destroy the nucleus pulposus, the more nucleus pulposus is obtained, the more pronounced the destruction of the disc. Although the clinical symptoms are eliminated or reduced at that time, the potential for disc function decline is greatly increased after the destruction of the disc. Be aware that the discs are functional!!! The intervertebral disc is like a fully inflated tire that acts as a shock absorber for the body, the nucleus pulposus is like the gas in the tire, the gas decreases, the tire deflates, and the shock absorber function decreases!