What are the methods for diagnosing lumbar disc herniation?

Written by Na Hong Wei
Orthopedics
Updated on January 06, 2025
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The diagnostic methods for lumbar disc herniation are essentially three-dimensional; that is, clinical symptoms plus physical examination combined with auxiliary examinations. First, let's talk about clinical manifestations, which include pain, functional impairment, and local sensory abnormalities in cases of lumbar disc herniation. Second, in the physical examination of lumbar disc herniation, the intervertebral disc often shows some deformation, and the most common is a reduction or disappearance of the lumbar spine's forward physiological curvature, referred to colloquially as "flatback," where the back appears flat like a board. Other findings may include spinal scoliosis and specific tender points, usually located next to the protruding vertebrae. Percussing these tender points may induce radiating pain to the buttocks or lower limbs. Additional examinations might reveal abnormalities in the strength or sensation of lower limb muscles at different stages, as various muscles and sensory areas are affected differently. Special tests such as the straight leg raise test, femoral nerve stretch test, and neck flexion test are generally positive. The most routine auxiliary examination involves taking x-ray images, followed by CT scans, which can directly visualize the location and extent of the disc herniation. Currently, magnetic resonance imaging (MRI) is also used, which has significant advantages. MRI provides three-dimensional images, showing the sagittal, coronal, and axial planes, which helps in better assessing the condition of herniated discs. Therefore, these are the areas covered in diagnosing lumbar disc herniation.

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Written by Lv Yao
Orthopedics
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Lumbar disc herniation nursing measures

Herniated lumbar discs require attention to several aspects during treatment, First, it is important to advise patients to sleep on a hard bed as much as possible, avoiding soft beds to facilitate the exercise of the lower back muscles; Second, try to minimize sitting and actions such as bending over and picking things up, as these can reduce the load on the lumbar spine, thus alleviating the condition caused by the disc herniation; Third, appropriate functional exercises can be performed, such as the small bird flying exercise and lower back muscle training; Fourth, in terms of diet, opt for plain and less stimulating foods, avoiding the consumption of high-protein, highly nutritious foods, which can increase body weight and thus increase the load on the waist, aggravating the herniated disc situation.

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Written by Lv Yao
Orthopedics
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Can a lumbar disc herniation heal by itself?

Lumbar disc herniation cannot heal on its own. The protrusion of the disc is due to degeneration of the nucleus pulposus, which herniates through a ruptured annulus fibrosus, compressing the nerves behind it and causing symptoms such as pain, numbness, and weakness when walking. In the early stages or upon the first occurrence of lumbar disc herniation, symptoms can be alleviated through conservative treatment, such as strengthening the muscles in the lower back, appropriately applying traction, and wearing a lumbar support to reduce symptoms and prevent the herniated disc from further compressing the nerves. If the herniation is severe and it is not the first occurrence of this condition, surgical treatment is recommended. Therefore, lumbar disc herniation cannot heal on its own.

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Written by Na Hong Wei
Orthopedics
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Lumbar disc herniation is where?

Where does lumbar disc herniation occur? Let's first discuss what a lumbar disc is. A lumbar disc is a fibrous pad located between the upper and lower vertebrae, which can be understood as a joint between the two vertebrae. Its outer layer is made up of a dense fibrous ring, formed in different combinations and arrangements, with a nucleus pulposus in the middle, which primarily functions to bear pressure from various directions and disperse it. Lumbar disc herniation occurs when, for various reasons such as aging, trauma, or pathological changes, the lumbar disc protrudes. If the protrusion does not break through the fibrous ring, it is called bulging. If it compresses and causes the fibrous ring to rupture, it is called herniation. Thus, the herniation can protrude backward, upward, or forward; however, it is mostly the backward protrusion that can cause symptoms by compressing nearby tissues, such as the spinal cord, blood vessels, and nerve roots.

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Written by Guan Yu Hua
Orthopedic Surgery
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How many days to administer fluids after minimally invasive surgery for lumbar disc herniation?

With the development of medical technology, currently for the treatment of lumbar disc herniation, such as when conservative treatment is ineffective—including lying on a hard bed, pre-heating the waist, taking blood-activating and pain-relieving medication, or drugs that nourish the nerves—some interventional surgeries are chosen if these do not provide relief. The main ones commonly used include ozone ablation, collagenase nucleolysis, percutaneous disc removal, and foraminoscopic technology, etc., all of which carry very low risk. The most commonly used is ozone ablation, which involves instant oxidation of the degenerated protruded nucleus pulposus. This destroys the proteoglycans, thereby making the proteoglycans lose their function. The cells produce proteoglycans, reducing the osmotic pressure of the nucleus tissue, which cannot maintain normal moisture, leading to shrinkage and loss of tissue. This increases the space, thereby reducing the symptoms of nerve compression caused by disc herniation. Usually, antibiotics are used post-surgery to prevent infection, generally for about three days. After the medication is completed, considering discharge and returning home for recovery is possible, followed by oral medication. (Please use medications under the guidance of a physician.)

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Written by Wang Fei
Orthopedics
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Can I take calcium tablets for lumbar disc herniation?

Lumbar disc herniation is a very common clinical disease, often affecting the lower back and causing discomfort. It frequently presents with numbness, swelling, pain, and even muscle atrophy in one leg. In the elderly, lumbar disc herniation may be associated with osteoporosis, as bone changes following osteoporosis can lead to poor vertebral stability, ultimately causing disc herniation. Elderly patients with both lumbar disc herniation and osteoporosis should take calcium supplements. However, for young and middle-aged adults who do not have accompanying osteoporosis, taking calcium supplements is not particularly beneficial.