Lumbar disc herniation is one of the common diseases, which is caused by the rupture of the annulus fibrosus and the pain caused by the herniated disc squeezing the nerve. When a patient perceives that he has manifestations of lumbar disc herniation, how is the clinical diagnosis? To what extent does the patient need surgery to recover? Faced with these problems, this time the Family Doctor Online was fortunate to invite Professor Long Houqing of Spine Surgery, the East Hospital of the First Affiliated Hospital of Sun Yat-Sen University, and he gave an explanation one by one.
What is the clinical diagnosis method for lumbar disc herniation?
The diagnosis of lumbar disc herniation can be done by CT or MRI to confirm the size of the lumbar disc herniation, the development stage and the relationship with the nerve. For these two methods of diagnosis, Professor Long Houqing said that he would recommend an MRI examination for patients. Compared with CT, MRI is not only radioactive, but also has a richer observation content. You can see the relationship between the intervertebral disc and the nerve root, the degree of nerve compression, and the overall condition of the entire intervertebral disc. In addition, nuclear magnetic examination plays an important role in the preliminary screening and elimination of infections and tumors.
Intervertebral disc herniation can basically be cured by conservative treatment. Professor Long Houqing said that intervertebral disc herniation is a benign disease. The so-called benign disease refers to a good overall prognosis. And most of them can be cured by conservative treatment. At present, patients can choose conservative treatment methods according to different conditions:
1, bed rest. Professor Long Houqing said that bed rest is currently the safest and most effective method. "Bed rest can reduce the edema of the nerve root. The herniated intervertebral disc will be slightly absorbed. At the same time, through rest, the nerve root will decrease with the activity of the lower limbs, the edema of the nerve root will be reduced, and the appearance of nerve irritation will be reduced. The literature strictly requires that 70% of patients who stay in bed for two weeks can get better."
2, taking drugs. clinically usually prescribe painkillers or dehydrating drugs to patients for the purpose of reducing edema and inflammation. Medication can achieve obvious therapeutic effects. For patients with severe pain, a little hormone can be used, but not for more than three days. This is something that the patient must pay attention to.
3, rehabilitation physical therapy. Local hyperthermia can improve local circulation and reduce edema; acupuncture in Chinese medicine can improve local muscle relaxation and protect patients' nerve function. But avoid violent massage. Professor Long Houqing said, "The so-called'I will push you back' in the advertisement is unrealistic." For patients with lumbar muscle strain, massage can improve the symptoms of pain; but for patients who have been diagnosed with lumbar disc herniation, massage is not effective.
However, patients who have no effect on the above conservative treatments, or whose condition has not improved and worsened, need to choose surgical treatment. "I feel weak in the legs and heavy walking, indicating that the nerve compression is serious. At this time, if the compression is not removed as soon as possible, it will also affect the speed of nerve function recovery, and even some dysfunction may remain." Professor Long Houqing said Tao. The patient's urinary and sexual dysfunction is also an important indicator of the need for surgery.
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