Types of lumbar intervertebral disc injury In clinical practice, according to the damage of the annulus fibrosus and the location of the disc contents, there are three types: ( 1 ) prolapsed disc (free type): refers to the protection of the intervertebral disc of the annulus fibrosus and the posterior longitudinal ligament of the spine by the damage is more serious, the protruding disc breaks through the posterior longitudinal ligament and free in the vertebral canal, the free protruding material can be slipped in the vertebral canal, compression of the cauda equina nerve and can produce adhesion with the cauda equina nerve, this type is the most difficult to treat. This type is the most difficult to treat. Clinical manifestations include lumbar pain, radiating pain in the buttocks and legs, which may be on one side or both sides. The body is often fixed in one position, and a change in position can cause severe pain. Because the detached intervertebral disc can move its position in the spinal canal, when the position is changed, the location of the pain in the lower limbs can also be changed. In the acute stage, coughing, sneezing, and even deep breathing can produce severe radiating pain. Dysfunction of the lumbar region and lower limbs occurs due to the pain, and the lumbar muscles become more tense or platysma lumbar. The pain can be aggravated by palpation or buckling of the lumbar region. CT and magnetic resonance imaging examination shows the prolapsed disc is visualized. ( 2 ) Lumbar intervertebral disc herniation: refers to the intervertebral disc, annulus fibrosus, and posterior longitudinal ligament are mildly damaged, the intervertebral disc presses toward the posterior longitudinal ligament, causing the intervertebral disc and posterior longitudinal ligament to protrude toward the posterior or lateral posterior at the same time, and this type is one of the most common in the clinic. This is the most common type of herniation in the clinic. If the herniation is toward the posterior, it is called central herniation. If the herniation is to the lateral posterior, it is called left or right-sided disc herniation. The clinical manifestations of this condition are mainly: low back pain, radiating pain in the buttocks and lower extremities. The central herniation occurs bilaterally, while the left or right herniation occurs unilaterally. The position of the pain is fixed and unchanging, and the pain worsens when coughing or sneezing. Various degrees of dysfunction may occur. When one side of the herniation is accompanied by small joint misalignment, there is obvious pressure pain in the paraspinal region. CT and magnetic resonance imaging can make a clear diagnosis. ( 3 ) Lumbar intervertebral disc bulging: refers to only the rupture of the inner intervertebral disc annulus fibrosus, while the outer intervertebral disc annulus fibrosus is intact, and the disc contents are squeezed to the ruptured inner intervertebral fibrous annulus, so that the posterior longitudinal ligament bulges backward, and it is the early manifestation of the intervertebral disc injury. Its clinical manifestations are: lumbar muscle tension, and there may be different degrees of lumbar pain and distension. Palpation and X-ray examination are generally indicative of small joint subluxation.