Hysteroscopy for lumbar disc herniation

Lumbar disc herniation is caused by excessive force on the waist in daily life and work, frequent strenuous activities, etc. Generally, people who engage in sports, office workers, white-collar workers, and heavy laborers are prone to lumbar disc herniation. Usually, you should pay attention to avoid excessive waist activities, bending over, and avoiding cold waist. Acupuncture and hot compress can be used to relieve it. So can hysteroscopy detect lumbar disc herniation?

Lumbar disc herniation can be divided into three types: bulging, protrusion, and extrusion. Lumbar disc herniation is a diagnosis of Western medicine, and there is no such disease name in traditional Chinese medicine. Instead, the disease is generally classified under the category of "low back pain" and "low back and leg pain". This disease is one of the more common lumbar diseases in clinical practice and is a common and frequently occurring disease in orthopedics. This is mainly because the various parts of the lumbar intervertebral disc (nucleus pulposus, annulus fibrosus and cartilage plate), especially the nucleus pulposus, have different degrees of degenerative changes. Under the influence of external factors, the annulus fibrosus of the intervertebral disc ruptures, and the nucleus pulposus tissue protrudes (or falls out) from the ruptured part to the back or inside the spinal canal, causing adjacent tissues, such as spinal nerve roots and spinal cord, to be stimulated or compressed, resulting in a series of clinical symptoms such as low back pain, numbness and pain in one or both lower limbs.

1. Symptoms and Signs

The symptoms of lumbar disc herniation are pain that radiates from the waist to the legs and is aggravated by bending over and raising the legs. This is because the nucleus pulposus of the lumbar intervertebral disc protrudes backwards, pressing on the nerves that control the legs, causing symptoms in the corresponding leg-controlled areas, such as pain, numbness, weakness and even urinary and bowel disorders.

2. Imaging examination

Magnetic resonance imaging can clearly show important information such as the protruding segment, the degree of disc degeneration, the protrusion direction of the nucleus pulposus, the compression site of the nerve, etc. It is currently the best examination method for lumbar disc herniation. Although MRI can well display important structures such as discs and nerves with high water content, it is blind to calcified tissue. Therefore, if surgical treatment is required, a lumbar CT scan is generally required.

3. Lumbar disc herniation and lumbar disc herniation

Lumbar disc herniation is an imaging diagnosis that almost every adult will have. This is just a reminder for everyone to be careful. Only when it becomes serious to a certain extent and lower limb symptoms appear, it is called lumbar disc herniation, that is, when radiating symptoms of the lower limbs appear: such as pain, numbness, weakness and even urinary and bowel disorders, then further treatment is needed. This is just like the points deducted for violating traffic rules. Almost everyone who drives has had points deducted, but only when 12 points are deducted will you need to retrain and take Subject 1 test.

4. Determination of the severity of lumbar disc herniation

The severity of imaging is often not positively correlated with the severity of symptoms. In other words, the judgment of the severity of this type of disease is dominated by symptoms, which is consistent with the principle that "doctors treat diseases, not films."

Common symptoms of lumbar disc herniation include pain, numbness, weakness, and urinary and bowel disorders, which increase in severity. Pain is the lightest, followed by numbness, then lower limb weakness, and the most serious is urinary and bowel disorders. They may occur simultaneously, or numbness may occur at the beginning and only transient pain may occur, but their recovery effects are different. Taking surgical treatment as an example, pain symptoms will be relieved by 80-90% immediately after surgery, and numbness symptoms will gradually decrease within six months to a year after surgery, but a small area of ​​numbness may remain; lower limb weakness symptoms may take 3-4 years to partially recover, and the most serious urinary and bowel disorders may not be able to recover after surgery. Therefore, once lower limb symptoms appear, you should go to the hospital for evaluation and treatment as soon as possible.

5. Preoperative evaluation of lumbar disc herniation

The surgical indications for lumbar disc herniation are: the lumbar disc herniation segment is consistent with the symptom segment, the VAS score is greater than 6 points, and the conservative treatment is ineffective. Of course, the above surgical indications are the bottom line. If the condition is more serious than this, more treatment is needed.

For example, there are two absolute indications for surgery: 1. Cauda equina syndrome: numbness of the skin in the saddle area (the part that touches the seat when riding a bicycle), decreased sensation, or urinary and bowel dysfunction (constipation or incontinence); 2. Weakness of the muscle strength of the corresponding nerve roots.

6. What kind of lumbar disc herniation is suitable for spinal endoscopic surgery?

Spinal endoscopy is one of the important methods for minimally invasive treatment of lumbar disc herniation. It only requires a 7mm incision to remove the protrusion that compresses the nerve root under visual conditions. Its treatment indications are: the protrusion segment is consistent with the symptom segment, the lower limb symptoms are more severe than the lumbar symptoms, the VAS score is greater than 6 points, and the conservative treatment effect is poor.