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Is there the most thorough method to treat lumbar disc herniation?
This paper introduces several commonly used conservative treatment methods: 1) epidural steroid injection: so-called sacral canal injection, that is, injection of steroid drugs (such as dexamethasone, prednisolone, hydrocortisone, etc. ) through the sacral canal into the epidural space. This method can inhibit the excitability of nerve endings walking in epidural space, and improve local blood circulation, so that local metabolic waste can be easily taken away from blood circulation, thus playing an anti-inflammatory role and achieving the purpose of relieving pain. However, if the huge disc herniation compresses the nerve root, the symptoms cannot be alleviated due to mechanical stimulation. 2) Sacral chemolysis, also known as "nucleolysis", is to dissolve some protease drugs to reduce or eliminate the pressure caused by nucleus pulposus protrusion on nerves. It is suitable for patients with a medical history of less than 2 months who are ineffective after other non-surgical treatments or have poor postoperative results, but it is forbidden for those who are allergic to protease drugs (this injection has been done before, and the risk will increase after re-injection), accompanied by lumbar spinal stenosis or lumbar disc herniation. Its complications are about 2% ~ 3%, and the common ones are allergic reaction, discitis, burning neuralgia, secondary intervertebral foramen stenosis or spinal canal stenosis. Therefore, the indications should be strictly controlled when applying this method. At present, it is reported that the effective rate of this method is about 60% ~ 70%. 3) Other methods, such as traction, massage, microwave, medicine, etc. Traction method is to use the traction state, the intervertebral space is enlarged, and the posterior longitudinal ligament of the intervertebral disc is tightened, so that the prominent nucleus pulposus of the intervertebral disc can be accommodated. This method is only suitable for patients with disc herniation or protrusion, but the fibrous ring and posterior longitudinal ligament are not ruptured, and it is ineffective for disc herniation. Massage and microwave therapy can relieve symptoms by relaxing tense muscles and increasing local blood circulation. Some dehydrating agents and hormones, such as mannitol and dexamethasone, or drugs that improve nerve metabolism, such as antipsychotics, can improve the inflammatory response of stimulated nerve roots to achieve the purpose of relieving pain.