Overview of conservative Chinese medicine treatment for lumbar disc After the diagnosis of lumbar disc herniation, except for cases with urinary and faecal dysfunction, extensive muscle strength and sensory loss or paralysis, non-surgical treatment can be used first, including rest on a flat hard bed, traction, hot compresses, manual tui-na repositioning and oral Chinese medicine. This is the main introduction of manual tui-na treatment. Tian Qingle, Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Nanjing Medical University After admission, patients are usually told to lie flat on a hard bed, reduce activities, walk on the floor and sit with a lumbar girth to protect the lumbar area, apply hot compresses to the lumbar area twice/day with traditional Chinese medicine and massage every other day, together with oral Chinese medicine or sedative drip of Danshen injection, which can significantly reduce the symptoms within two weeks, and some patients can see improvement within a week. Lumbar intervertebral disc protrusion massage method Position: patient lying prone with a soft pillow on the chest. Steps: After determining the pain point, first loosen both sides of the lumbaris major muscle with the rolling method for about 15 minutes, then use the one-finger Zen pushing method to flick the affected side of the lumbaris major muscle for 5 minutes, paying attention to the point of the technique to avoid excessive pain stimulation, causing discomfort to the patient, and then massage the painful parts of the patient’s waist and legs with the rolling method for about 10 minutes. Make the patient lie on his side, and use the lumbar spinning plate method to spin the plate on both sides of the patient, so that the protruding intervertebral disc is reset, after shaking the affected limb several times, ask the patient to lie down and rest for 10 minutes. After the massage, the straight leg treatment test can be checked and the muscle strength and sensory disorder area can be changed. Most of the patients had significant reduction of symptoms at that time, and the symptoms were relieved after several times of massage. Contraindications to massage: For pregnant women, spinal slippage, and those with severe heart disease, massage therapy should not be used to avoid the risk of miscarriage, aggravation of spinal slippage or heart failure. For those who are suspected of having vertebral tuberculosis, further examination should be conducted to confirm the diagnosis, and if there is tuberculosis, massage treatment cannot be done. For central herniation, herniated nucleus pulposus and cartilage plate rupture, early surgery should be performed and manual massage is not recommended. For those with spinal stenosis, the effect of massage is poor, and surgery is generally used. For some patients whose symptoms cannot be completely eliminated, treatment such as sacral drip and epidural closure can be combined. Surgical treatment of lumbar disc herniation Percutaneous lumbar disc retraction Under X-ray fluoroscopic guidance, the nucleus pulposus tissue is partially or completely removed by direct insertion of special instruments into the disc, thus reducing the surface tension of the herniated nucleus pulposus tissue, relieving the damage to the nerve roots and eliminating the symptoms. Lumbar disc herniation nucleus pulposus surgery Indications for lumbar disc herniation nucleus pulposus surgery: (1) Lumbar disc herniation with a history of more than six months, ineffective after six months of conservative treatment, pain not relieved, straight leg raise test (+) or sometimes light and heavy, or neurological symptoms continue to worsen. (2) In typical central lumbar disc herniation, surgery should be performed as soon as possible if it is combined with numbness in the saddle area or urinary and fecal disorders. (3) In atypical lumbar disc herniation, if the symptoms do not decrease after long-term conservative treatment, and the clinical symptoms worsen after activity, and the lumbar disc herniation is confirmed by special imaging, nucleus pulposus removal should be performed. (4) Older patients with lumbar disc herniation should be considered for surgery if they have combined pseudo-slip, vertebral body posterior margin hyperplasia, or secondary spinal stenosis. Preoperative preparation for lumbar disc herniation nucleus pulposus removal: Preoperatively, the patient should be made to practice defecation in bed to avoid postoperative wound pain, inability to get up, and discomfort caused by unaccustomed bedside defecation. Clean enema should be given before surgery to avoid postoperative constipation. Give the patient a briefing on his condition and seek his cooperation during the operation, and give him a sedative after the operation to ensure rest. Lumbar disc herniation nucleus pulposus removal surgery: (1) hemivertebral segment exposure, intervertebral opening and lumbar disc nucleus pulposus removal surgery. Applicable to typical paracentral type of disc herniation. After surgery, lie flat, antibiotic treatment for 7 days, stitches are removed in 2 weeks, and you can go down with a lumbar girth 3 days after surgery and resume normal work after 3 months. (2) Hemilaminectomy, hemivertebral dissection, and lumbar discectomy. It is suitable for typical unilateral herniation or cases of lumbar disc herniation with atypical clinical symptoms and unclear protrusion gap with combined congenital lumbar developmental malformation, and the postoperative treatment is the same as before. (3) Total laminar exposure, total laminectomy and lumbar disc nucleus pulposus removal. It is suitable for cases with moderate to typical herniation, especially in combination with dorsal medullary or cauda equina nerve compression and secondary spinal stenosis. Postoperatively, antibiotics are applied in a flat position for 7 days, stitches are removed in 2 weeks, and the patient is placed on the floor after 6 weeks and reviewed in 3 months. Normal work was resumed after 6 months. Postoperative complications of lumbar disc herniation nucleus pulposus removal: infection, incidence 0.8%; vascular injury; nerve injury; organ injury. Conclusion: The above details the treatment methods for lumbar disc herniation for you. Different treatment methods for lumbar disc herniation do not play the same role for patients with different disease conditions. Patients can choose the right treatment for their lumbar disc herniation according to their disease progress and needs.