1, lumbar disc herniation surgery
1. Extraperitoneal lumbar discectomy: Because posterior discectomy has great damage to the vertebral segment, and it is not easy to completely remove the diseased disc, combined with bleeding and hematoma at the operation site, it is easy to cause nerve root adhesion, so anterior discectomy is recommended. Its advantages are: it can expose the whole intervertebral space well, and can treat lumbar 4 ~ 5 and lumbar 5 ~ sacrum 1 intervertebral disc at the same time; It is convenient for bone grafting after intervertebral disc removal, maintaining the height of intervertebral space and realizing bone fusion.
2. Extraperitoneal anterior lumbar intervertebral joint resection: This operation is mainly used for patients with discogenic low back pain, lumbar (anterior) disc herniation caused by traumatic (degenerative) intervertebral arthritis and some cases with poor curative effect after posterior decompression. The operation process is similar to the above, but it requires that the whole vertebral body segment be taken out during the operation, and then iliac bone implantation, interface internal fixation or artificial intervertebral disc implantation are performed. This kind of operation has great injury and much bleeding during operation, so the case selection should be cautious.
3. Percutaneous lumbar discectomy: This kind of percutaneous lumbar discectomy is a new technique developed by German neurosurgeons for the first time in clinic and is being popularized in China. Its biggest advantage is that the nucleus pulposus is removed by endoscope, so the injury is small, the blood loss is small and it is easy to master after training. However, its case selection is strict and limited by equipment. Because of its high price, it is beyond the affordability of ordinary hospitals.
Fourth, the treatment of lumbar disc herniation by posterior disc endoscope: Posterior disc endoscope surgery is a minimally invasive technique developed by SofamorDanek Company 1998 in the United States, which provides patients with a surgical method with little injury, quick recovery and definite curative effect. Introduced from China 1999, it has been widely used in various places.
2. Preventive measures
1. Enhance the strength of lumbar muscles, increase the strength of anterior ligament, posterior ligament and lateral ligament of lumbar spine, prevent intervertebral disc from being compressed, and break through normal ligaments and muscles of human body.
2. Pay special attention to the exercise of abdominal muscles, not only because abdominal muscles and back muscles are mutually antagonistic muscles, but also the joint efforts of both sides can strengthen the stability of the entire lumbar spine. At the same time, maintaining stable abdominal pressure by strengthening abdominal muscles can also ensure the stability of lumbar spine and the strength of back muscles.
3. In the acute stage, patients with lumbar disc herniation should lie prone on a hard bed and rest in crocodile style to relieve pain and promote healing and recovery.