Is Lumbar Disc Herniation a Serious Condition? What Should I Do?

Update Date: 2024-05-20 Source: Network

Lumbar disc herniation can be severe, and patients with mild symptoms can be relieved or cured through non-surgical treatment. However, surgical treatment should be considered as soon as possible for patients with severe symptoms. Lumbar disc herniation is one of the more common diseases, mainly caused by degenerative changes in various parts of the lumbar disc (nucleus pulposus, fibrous ring, and cartilage plate), especially the nucleus pulposus. Under the action of external forces, the fibrous ring of the intervertebral disc ruptures, and the nucleus pulposus protrudes (or herniates) from the rupture site to the rear or within the vertebral canal, leading to irritation or compression of adjacent spinal nerve roots, resulting in a series of clinical symptoms such as low back pain, numbness and pain in one or both lower limbs.

Lumbar disc herniation is most commonly seen at the L4-5 and L5-S1 levels, accounting for approximately 95% of cases. Most patients with lumbar disc herniation can be relieved or cured through non-surgical treatment. The principle of non-surgical treatment is not to restore the herniated disc tissue to its original position, but to change the relative position of the disc tissue and the compressed nerve root or partially reduce it, relieve the compression on the nerve root, release the adhesion of the nerve root, eliminate the inflammation of the nerve root, and thus alleviate the symptoms.

Non-surgical treatment is mainly suitable for:

Young patients, first-time onset, or short duration of illness;
Patients with mild symptoms that can be relieved spontaneously after rest;
Patients with no significant narrowing of the spinal canal on imaging examination.

Surgical treatment:

(1) Surgical indications:

History of more than three months with ineffective or frequently recurrent and severe pain despite rigorous conservative treatment;
First-time onset with severe pain, especially in the lower limbs, making it difficult for the patient to move or sleep and necessitating forced positioning;
Combined with signs of cauda equina nerve compression;
Presence of single nerve root paralysis with muscle atrophy and decreased muscle strength;
Combined with spinal stenosis.

(2) Surgical methods:

Posterior lumbar incision with partial removal of the vertebral lamina and facet joints, or intervertebral disc removal through the interlaminar space. For central disc herniation, laminectomy is performed, followed by extradural or intradural disc removal. For patients with combined lumbar instability or lumbar spinal stenosis, spinal fusion surgery is required.