How to treat lumbar disc herniation

If lumbar disc herniation occurs, you must take appropriate treatment methods and not let your condition continue to worsen. You can use corticosteroids to improve the condition. This type of drug will not cause much harm to the patient's body, but it cannot be used for a long time. If the patient's condition is more serious, he must take appropriate surgical treatment.

(5) Corticosteroids Epidural injection of corticosteroids is a long-acting anti-inflammatory agent that can reduce inflammation and adhesions around nerve roots. Generally, long-acting corticosteroid preparations + 2% lidocaine are used for epidural injection once a week, 3 times as a course of treatment, and another course of treatment can be used after 2 to 4 weeks.

(6) Chemical nucleus pulposus dissolution uses collagenase or papain, which is injected into the intervertebral disc or between the dura mater and the protruding nucleus pulposus to selectively dissolve the nucleus pulposus and annulus fibrosus without damaging the nerve roots, thereby reducing the pressure in the intervertebral disc or reducing the size of the protruding nucleus pulposus, thereby alleviating symptoms. However, this method carries the risk of allergic reactions.

2. Percutaneous nucleotomy/laser vaporization of the nucleus pulposus

Through the use of special instruments, the intervertebral space is entered under X-ray monitoring, and part of the nucleus pulposus is crushed, sucked out or vaporized by laser, thereby reducing the pressure within the intervertebral disc and relieving symptoms. It is suitable for patients with bulging or mild herniation, but not suitable for patients with lateral recess stenosis or obvious herniation, or those whose nucleus pulposus has prolapsed into the spinal canal.

3. Surgery

(1) Indications for surgery: ① Patients with a history of more than three months and ineffective conservative treatment or those with effective conservative treatment but frequent relapses and severe pain; ② Patients with first attack but severe pain, especially with obvious symptoms in the lower limbs, who have difficulty moving and sleeping and are in a forced posture; ③ Patients with combined compression of the cauda equina; ④ Patients with single nerve root paralysis, accompanied by muscle atrophy and decreased muscle strength; ⑤ Patients with combined spinal stenosis.

(2) Surgical method: Through a posterior lumbar incision, partial resection of the lamina and articular processes, or intervertebral disc resection through the interlaminar space. For central disc herniation, laminectomy is performed followed by epidural or intradural discectomy. Patients with lumbar instability and lumbar spinal stenosis require spinal fusion surgery at the same time.

In recent years, minimally invasive surgical techniques such as microdiscectomy, microendoscopic discectomy, and percutaneous transforaminal endoscopic discectomy have reduced surgical damage and achieved good results.