What disease is lumbar support (lumbar disc herniation, nerve compression)? How can it be cured?

How to treat lumbar disc herniation? This question is rather general. The treatment of lumbar disc herniation can be roughly divided into three categories: 1. Non-surgical treatment includes: 1, bed rest 2, drug therapy 3, traction therapy 4, physical therapy 5, massage therapy 6, acupuncture therapy 7, substitution therapy 8, blocking therapy 9, small needle knife therapy 10, reduction method (transverse process straight support expansion of nucleus pulposus or spinal reduction treatment). Surgical treatment includes 1, conventional open surgery (including hemilaminectomy, total laminectomy and transabdominal intervertebral disc surgery) 2, minimally invasive discectomy 3, percutaneous aspiration 4, artificial lumbar disc replacement 3, interventional therapy including 1, collagenase chemolysis 2, ozone injection 3, ultra-low temperature ablation 4, radiofrequency thermocoagulation target puncture technology 5, non-invasive treatment. 6, minimally invasive treatment (CT-C arm combined with guided hyperthermia repair (IDET)) (1) Because of the special structure of lumbar intervertebral disc, many general drugs are difficult to treat, so general western medicine can only relieve pain and clinical symptoms. There are some therapeutic drugs in traditional Chinese medicine, such as Tibetan medicine, physical therapy and iron removal, but most other drugs still can't achieve the goal of radical treatment of lumbar disc herniation. (2) Traction treatment As we all know, lumbar disc herniation can be divided into three types according to the size of the protrusion: bulging type, protruding type and prolapse type. According to the severity of clinical symptoms, patients with lumbar disc herniation are divided into acute stage and remission stage. At the first onset, general hospitals will advise patients to use traction treatment first. Traction mainly uses mechanical force to pull the intervertebral space, reducing the internal pressure of the intervertebral disc and slightly relieving the compression of the protrusion on the nerve. Theoretically, it is correct, but the clinical treatment effect is really not ideal. This is mainly because the strength of traction varies from person to person and it is difficult to hold it; The other is that the choice of indications is difficult to distinguish accurately; Another is the patient's cooperation. For patients with lumbar disc herniation, the pressure in the disc is very high at this time, which can be cured by traction, but it is ideal to stay in bed during traction. If you walk or take a car immediately after traction, the high pressure in the intervertebral disc will recover, resulting in ineffective traction. Traction is only suitable for patients with disc herniation. If the intervertebral disc has caused protrusion and prolapse, traction is completely ineffective and may aggravate the patient's symptoms. Traction is a contraindication for patients with acute lumbar disc herniation. Because the patient is in an acute phase, the edema and inflammatory stimulation of nerve roots will cause tension and spasm of lumbar muscles. If traction is carried out at this time, it will strain the lumbar muscle fibers, cause low back pain and aggravate clinical symptoms. To sum up, traction is only suitable for patients with simple lumbar disc herniation, and it must be used when the symptoms are not serious. In order to relieve clinical symptoms, it is forbidden for patients with lumbar disc herniation, prolapse, spinal stenosis and acute lumbar disc herniation. (3) Physical therapy, massage therapy and acupuncture therapy Physical therapy includes electrotherapy, infrared radiation, hyperthermia and other methods, and the therapeutic purpose is basically the same as massage and acupuncture. It is mainly to relieve the clinical symptoms of patients, not radical measures. Because most patients with lumbar disc herniation are accompanied by chronic lumbar muscle strain and piriformis muscle tension, the nerves pressed by lumbar disc herniation cause low back and leg pain and muscle spasm at the place where the nerves pass, general hospitals will use physical therapy, massage, acupuncture and other treatment methods to relieve muscle tension and spasm. Therefore, all patients who have done physical therapy know that it will be more comfortable when doing physical therapy, and it will be the same after not doing it. Therefore, physical therapy, massage, acupuncture and other treatments are only used for the synergistic treatment of lumbar disc herniation. (4) Blocking therapy Blocking therapy can be divided into two application methods, one is intraspinal blocking and the other is nerve root blocking. As the name implies, intraspinal canal occlusion is to inject drugs directly into the spinal canal, and nerve root occlusion is to inject drugs around the nerve root. The drugs injected are mainly adrenal glucocorticoid plus local anesthesia. Under the action of hormones, aseptic inflammation and edema of nerve roots can be alleviated and eliminated; Anesthetics are analgesic, and nerve anesthesia reduces its sensitivity. We all know why lumbar disc herniation can cause low back and leg pain, mainly because the nucleus pulposus of lumbar disc compresses the nerve, leading to nerve root edema and aseptic inflammation, so the function of sealing is to relieve the pain, and the protrusion compression can not be solved. When the drug effect is blocked, the symptoms of low back and leg pain will recover immediately. (5) Needle knife therapy Needle knife therapy is divided into water needle knife and small needle knife. Water acupotomy is an injection-type acupuncture instrument that combines the "needle scalpel" of Zhang Zhongjing's medical shrine in Qing Dynasty with modern medical water acupuncture to soften the essence of other needle scalpel therapies. As a product of the combination of traditional medicine and modern medicine, water knife therapy is a new type of injection microsurgery between acupuncture and open surgery. It is based on local anatomy of soft tissue, three-dimensional anatomy, three-dimensional anatomy of static and dynamic, biomechanics, bioinformatics, meridian theory, aseptic inflammation, static and dynamic balance and pharmacology of Chinese and Western medicine, and has broad prospects in treating soft tissue trauma diseases and spinal related diseases. Small needle knife therapy is a new therapeutic method developed on the basis of acupuncture and blocking therapy, and its therapeutic effect has been gradually deified in recent years. Small needle knife is a kind of surgical instrument, which widely strips and loosens the pain points of patients with low back and leg pain, and then injects local anesthetic drugs and hormone drugs to play an anti-inflammatory and analgesic role. The purpose of small needle knife is to create conditions for expanding the closed range. Therefore, small needle knife therapy is actually an improvement of closed therapy, and the therapeutic effect is equivalent to closed therapy. Because adrenal glucocorticoids are used in the treatment process, it is not advisable to use them more. The side effects of hormones can cause osteoporosis, gastrointestinal reaction, acne hirsutism, centripetal obesity and so on. , diabetes and hypertension patients are prohibited. (6) Alternative therapy for lumbar disc herniation: Using pure natural serrate mackerel cartilage powder to restore the regeneration of human lumbar cartilage fibrous ring has become a brand-new medical attempt for lumbar disc herniation in advanced countries since 1980s. Because lumbar disc herniation is caused by the rupture of fibrous ring (a kind of cartilage). Clinical practice has proved that the cartilage powder of Sparus serrata can regenerate cartilage. Now, in Europe, the extract of Sparus serrata has been recognized as a medicine. In the United States, OAM (Bureau of Alternative Medicine) also studies and promotes shark cartilage as a part of alternative medicine treatment, while in Japan, pure natural serrate snapper cartilage powder is directly used as a part of alternative medicine treatment, which is widely used in the clinical treatment of lumbar disc herniation because of its no natural side effects. The dose of 7.5g/ day is also a part of Japan Shark Cartilage Popularization Association. The new research has brought a bright dawn for human beings to completely overcome lumbar disc herniation. (7) Surgical treatment 1. Conventional open surgery: Conventional open surgery includes: total laminectomy, hemilaminectomy, transabdominal intervertebral disc surgery and vertebral body fusion. The purpose of the operation is to directly remove the nucleus pulposus of the diseased lumbar intervertebral disc, relieve the nerve root compression, and achieve the therapeutic purpose. Due to the limitation of the special physiological position of the lumbar spine, the operation destroys the normal physiological structure of the lumbar spine, which leads to a series of adverse reactions, such as postoperative instability of the lumbar spine, postoperative scar tissue adhesion, accidental injury of nerve roots during the operation, so most patients are afraid of the operation. How to avoid the above adverse reactions during the operation? This has always been a big problem in the medical field. 2. Endoscopic minimally invasive surgery of intervertebral disc In order to avoid the big injury of conventional open surgery and reduce the risks and complications of surgery, although microsurgery and arthroscopic assisted lumbar disc surgery can reduce the damage to normal bones and joints during surgery, minimally invasive surgery is also a kind of surgery with risks and complications. Another main problem is that it is difficult to completely remove the diseased nucleus pulposus of lumbar intervertebral disc after the surgical field of vision becomes smaller, which increases the risk of unsuccessful operation. 3. Percutaneous aspiration: Most patients with lumbar disc herniation are caused by increased pressure in the disc. Percutaneous aspiration can significantly reduce the internal pressure of intervertebral disc and reduce the protrusion of intervertebral disc, thus alleviating or eliminating the symptoms of nerve compression caused by protrusion. The advantage of this method is that the intraoperative injury is small, but the disadvantage is that the operation is mainly decompression, which is effective for lumbar disc herniation, lumbar disc herniation and calcification, and the operating surface is too narrow. (8) Collagenase chemolysis therapy The nucleus pulposus of human intervertebral disc is composed of water, fibrous tissue and proteoglycan. The full name of collagenase is collagenase, which can dissolve bone marrow proteoglycan. However, the human body is allergic to protein and enzymes, which is life-threatening, so this therapy has been banned abroad; Furthermore, if collagenase dissolution therapy fails, extensive scar adhesion will be formed inside and outside the intervertebral disc, which will bring difficulties to the follow-up treatment. At present, collagenase has been basically banned in regular hospitals in China, but some private hospitals or individuals have adopted this method to treat lumbar disc herniation. (9) ozone injection therapy: high concentration ozone has the effect of convergence and gasification. With this function, few hospitals have adopted the treatment of lumbar process in recent years. Theoretically, injecting ozone can vaporize and concentrate the nucleus pulposus of lumbar intervertebral disc, but what are the chemical reactions and complications after ozone enters the spinal canal? This requires further observation and research. Judging from the current patient feedback, the success rate of this treatment is not too high. (10) The best method of interventional therapy is non-invasive or minimally invasive therapy. The tissue structure of intervertebral disc is like a squashed egg, the fibrous ring is like protein, and the nucleus pulposus in the center is like egg yolk. Fibrous ring is usually composed of type I collagen, which is sensitive to heat and can be stretched under external force. 60? Around c, the hydrogen bond of collagen began to mutate. Under the guidance of CT and C-arm fluoroscopy, the temperature-controlled hyperthermia intervertebral disc repair is to use a hollow puncture needle to enter the intervertebral disc, then use a catheter to enter the intervertebral disc through the puncture needle, and set a heating coil at the head of the catheter. Under the monitoring of CT and C-arm fluoroscopy, it is clear that the catheter is located in the intervertebral disc, and then it can be heated to contracture the type I collagen in the annulus fibrosus and close the fissure of the annulus fibrosus, thus achieving the therapeutic purpose. In layman's terms, some of them are like hot glue tire repair of automobile tires. Suitable for young people with discogenic low back pain. The mechanisms of "temperature control hyperthermia repair -IDET" and "CT-guided interventional drug repair -PRT" are completely different from other interventional therapies. IDET and CT-guided interventional drug repair -PRT can achieve the purpose of healing by repairing the ruptured annulus fibrosus in the intervertebral disc, while other interventional therapies are to remove or dissolve the nucleus pulposus in the intervertebral disc and achieve the purpose of healing through decompression. For a better understanding, for example, would you choose to deflate a flat tire with enough air and cracks? Or choose to repair the tire? The herniated intervertebral disc is like a completely inflated burst tire. In addition, strengthening back muscle exercise (such as swimming) and wearing waist protection can alleviate further development!