We all know that lumbar disc herniation is very common in our lives, especially when it occurs in some middle-aged and elderly people, it is really very dangerous, but many people do not know that lumbar disc herniation is happening What should I do when I’m in, in fact, experts teach you exactly what to do to better treat this lumbar disc herniation.
1. What is the best examination for diagnosing lumbar disc herniation? Under what circumstances is it necessary to do this examination?
magnetic resonance imaging (MRI) is the most suitable non-radiation, non-invasive imaging method for diagnosing lumbar disc herniation. When the above pictures describe the typical clinical symptoms of lumbar disc herniation, the orthopedic surgeon finds positive signs of lumbar disc herniation through physical examination, and he needs to do a lumbar MRI examination to confirm the diagnosis. Of course, there may be some patients with metal, dentures, heart stents, metal implants, or other reasons that cannot be MRI examination, or the examination results are not consistent with clinical manifestations, you can choose to do lumbar CT or CT myelography as an alternative. Electromyography cannot identify the cause of nerve compression, and can only be used as an auxiliary examination method to determine other possible comorbidities.
2. Can lumbar disc herniation heal itself? What is the final outcome of the herniated disc tissue? (Subvert common people’s perception)
If lumbar disc herniation happens unfortunately, there is no need to be too nervous, especially young patients, who are always worried about such a young waist. If something goes wrong, what can I do in the future? As the disease progresses, the herniated lumbar intervertebral disc tissue usually (but not all) will atrophy/degenerate. Most patients will gradually improve their symptoms regardless of treatment. In other words, lumbar disc herniation has a certain healing ability. This may subvert the cognition of most patients, and this is one of the reasons why bed rest can alleviate a herniated disc.
So most patients with lumbar disc herniation do not need surgery, but please remember that not all patients can heal on their own. When the herniated disc compresses the nerves, or even after the herniated disc, conservative treatment is ineffective, you must choose surgery or interventional treatment , Do not choose surgery easily, and can not reject surgery.
3: Does traction have an effect on lumbar disc herniation? What is the role of auxiliary treatment measures such as acupuncture, electrical stimulation, waist circumference, and percutaneous electrical stimulation in the treatment of lumbar disc herniation?
For most patients, once the lumbar disc herniation is diagnosed The first reaction is to do all conservative treatment measures such as traction, physical therapy, acupuncture, massage, electrotherapy, and Chinese medicine. Among them, traction is the most widely used treatment method. Even so, there is no clinical evidence to support or oppose traction for the treatment of intervertebral disc herniation. If traction is not effective, it will only temporarily reduce nerve root compression and relieve symptoms. But in any case, traction is absolutely impossible to reset the herniated intervertebral disc.
is more uncertain in the effect of auxiliary treatment measures such as acupuncture, electrical stimulation, waist circumference, and transcutaneous electrical stimulation. It is not recommended or opposed. For the treatment of intervertebral disc herniation. In fact, no matter which option the patient chooses, the symptoms can be alleviated after a period of natural course of the disease. Those who choose traction think that traction has played a role; those who choose acupuncture think that acupuncture and moxibustion have cured the herniated disc; It shows the miraculous effect of the secret recipe. As everyone knows, the magical intervertebral disc "self-healing" actually played a role.
4: Which is the better effect of surgical treatment vs. medication alone or interventional therapy?
For patients with mild low back pain symptoms, drug therapy, interventional therapy or surgical resection can obtain satisfactory short-term and long-term clinical effects; for severe symptoms , Orthopedics judge patients who need surgery, the effect of surgery is significantly better than drugs or interventional treatment. Although discectomy and decompression surgery can alleviate clinical symptoms for a long time, it should be noted that 23-28% of patients may have chronic back pain or leg pain (or recurrence rate) after surgery.
5. If surgery or intervention is necessary, when is the best time for surgery or intervention?
Although most symptoms of lumbar disc herniation can be relieved on their own, patients with early surgery/intervention can recover faster and have better long-term neurological recovery. The symptoms are serious, and 6 months of treatment is ineffective through active and regular conservative treatment. The doctor recommends surgical treatment, indicating that your condition is no longer a group capable of self-healing. At this time, do not hesitate. It is recommended to perform surgery within 6 months . Existing evidence shows that if surgery is necessary, early onset(6-12 months) Surgery patients have faster postoperative recovery, better surgical results, better nerve function recovery, and lower surgical risks.
6: If surgery is necessary, choose minimally invasive or traditional open surgery?
Traditional open surgery and modern minimally invasive surgery can achieve the same effect. There is no authoritative clinical evidence to support or refute the effect of disc mirror/foraminal mirror is better than traditional open Surgery, considering that the former has obvious minimally invasive and cost-effective advantages, it has become more and more mainstream surgical methods. For patients, it should be noted that minimally invasive surgery has a certain learning curve. Try to choose an orthopedic surgeon with a larger amount of minimally invasive surgery (you can ask friends in the hospital or recommend them), so as to minimize the risk of surgery.
7. Which interventional treatments have a positive effect on lumbar disc herniation?
For patients with severe low back pain and conservative treatment ineffective, enhanced myelography-guided dural hormone injection (similar to spinal anesthesia, local sealing treatment) can be used Relieve the pain of lower limbs caused by lumbar disc herniation within 2-4 weeks, and the more severe the nerve root compression, the better the intervention effect.
Other interventional treatments such as intradiscal ozone injection therapy, plasma intervertebral disc radiofrequency ablation, plasma disc decompression, electrothermal disc decompression therapy, etc. These interventional methods are currently not effective, and patients are advised to choose the above methods carefully!
In fact, many people do Knowing that lumbar disc herniation is also very common in life, so everyone must be treated with this expert’s advice. It can be treated by surgery or usually by medication, because this is also Very importantly, it can make the lumbar disc protrusion become particularly healthy and no longer cause some pain.
