Lumbar disc herniation is very troublesome for young people and middle-aged and elderly people today. First of all, although disc herniation does not seem serious, it will actually have a great impact on the patient's standing and cause strain on the joints. Generally, relevant treatments can be received through non-surgical or surgical methods. Prognosis Most cases can be cured by non-surgical methods, and surgical cases generally have a good prognosis. Pathogenesis 1. Main cause It is well known that the lumbar intervertebral disc is subjected to strong compressive stress during the load and movement of the spine. After about 20 years of age, the intervertebral disc begins to degenerate, which becomes the basic cause of lumbar disc herniation. In addition, lumbar disc herniation is associated with the following factors: (1) Trauma: Observations of clinical cases have shown that trauma is an important factor in intervertebral disc herniation, especially in children and adolescents. When the spine is lightly loaded and rotated rapidly, horizontal rupture of the annulus fibrosus may occur, while compressive stress mainly causes rupture of the cartilage endplate. Some people also believe that trauma is only a triggering factor for intervertebral disc herniation. The original lesion is that the painless nucleus pulposus protrudes into the inner annulus fibrosus, and trauma causes the nucleus pulposus to further protrude to the outer annulus fibrosus which is innervated by nerves, thus causing pain. (2) Occupation: Occupation is closely related to lumbar disc herniation. For example, car and tractor drivers are in a sitting and bumpy state for a long time, so when driving a car, the pressure in the intervertebral disc is high, which can reach 0.5kPa/cm2. When the clutch is pressed, the pressure can increase to 1kPa/cm2, which can easily cause lumbar disc herniation. People who engage in heavy physical labor and weightlifting are more likely to suffer from intervertebral disc degeneration due to excessive load. When bending over and lifting a 20kg weight, the pressure inside the intervertebral disc can increase to more than 30kPa/cm2. (3) Genetic factors: There are reports of familial incidence of lumbar disc herniation, but there is little data in China. In addition, statistics show that the incidence rate among Indians, African blacks and Inuit is significantly lower than that of other ethnic groups. The reasons for this need further study. (4) Congenital abnormalities of the lumbar spine: Deformities of the lumbar spine can increase the incidence of the disease, including sacralization, lumbarization, hemivertebra deformity, facet joint deformity and articular process asymmetry. The above factors can change the stress on the lower lumbar spine, thus becoming one of the factors that increase the intra-disc pressure and make it more susceptible to degeneration and injury. |
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