Can a second surgery be performed for lumbar disc herniation?

Written by Cheng Bin
Orthopedics
Updated on November 22, 2024
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Firstly, it should be clarified that for patients with lumbar disc herniation, if the condition recurs after surgery, a second operation is completely feasible. This is because there are many intervertebral discs involved, including L3-L4, L4-L5, and L5-S1, all of which can lead to lumbar disc herniation and subsequently cause symptoms of back and leg pain. Even if the patient has already undergone surgery for L4-L5, it cannot be guaranteed that L3-L4 or L5-S1 will not develop disc herniation. Therefore, it is possible for patients with lumbar disc herniation to undergo a second surgical treatment.

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Written by Cheng Bin
Orthopedics
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Lumbar disc herniation symptom exercise

There are many exercises for lumbar disc herniation, such as the "little swallow" exercise, practicing lifting the buttocks while lying in bed, performing the bridge pose, supporting your body with three and a half points, and actively engaging in swimming. These exercises can strengthen the patient's lower back muscles, thereby better protecting the lumbar spine and alleviating symptoms of lumbar disc herniation. Additionally, for patients with lumbar disc herniation, besides exercise, it is important to keep warm. Avoid prolonged sitting or standing, avoid excessive bending to pick up heavy objects or lifting heavy weights. It is best to use a lumbar support belt, protect the lumbar spine, sleep on a firm bed. Also, locally apply heat actively, combined with acupuncture, electric heating, cupping, massage, traction, and other physical therapies.

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Written by Na Hong Wei
Orthopedics
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What should I do if I have a lumbar disc herniation?

After a lumbar disc herniation, it is essential to first determine the type of herniation you have. Clinically, lumbar disc herniations can be categorized into protrusion, prolapse, extrusion, and sequestration, with protrusion being the most common. Once the type of herniation is identified, treatment can begin. Currently, the treatment methods are diverse and can be broadly classified into six categories. The first is internal treatment with traditional Chinese medicine. Traditional Chinese medicine classifies lumbar disc herniation into four types, each treated with different medications. The second is external treatment with traditional Chinese medicine, such as herbal fumigation and plaster application. The third is traction, which includes bed traction and manual massage. The fourth is acupuncture. The fifth category includes other therapies, starting with resting on a hard board bed for approximately a week, followed by techniques like small needle knife therapy, intradiscal injection, sacral canal injection, and ozone therapy. If conservative treatments prove ineffective, or if symptoms worsen during treatment, surgical intervention may be necessary. Surgical treatment is generally indicated in the following four situations: patients with spinal stenosis, patients who do not respond to conservative treatment or who experience recurrent symptoms after recovery, patients with worsening neurological symptoms, and patients with central lumbar disc herniation causing incontinence. These are the conditions mentioned above.

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Written by Na Hong Wei
Orthopedics
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Can a herniated lumbar disc be massaged?

Lumbar disc herniation can be treated with massage, and as a part of conservative treatment, massage is a very important method with generally good effects. Its role is to relieve muscle spasms, expand blood vessels, increase local blood circulation, and promote cellular metabolism of soft tissues. The techniques primarily include rolling and rubbing, supplemented by grasping and grinding methods. The main acupuncture point targeted is the Jiaji point, centered on the lesion between the two vertebral bodies. Other auxiliary acupuncture points include Yaoyangguan, Mingmen, Shenshu, Bahui, Huanjiao, Yinmen, Fucheng, Weizhong, Chengshan, and Yanglingquan.

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Written by Na Hong Wei
Orthopedics
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Is a herniated lumbar disc serious?

Lumbar disc herniation is primarily due to degeneration of the lumbar disc or secondary pathological changes caused by this degeneration, which then stimulate blood vessels, nerve roots, and the spinal cord, leading to a series of clinical symptoms. Lumbar disc herniation is categorized into four types. The mildest type is the bulging type, followed by the protruding type, the more severe extrusion type, and finally the most severe, the sequestration type. Generally, lumbar disc bulging is relatively mild and conservative treatment is usually effective. Depending on the site and degree of compression, lumbar disc herniation may be treated conservatively, but some cases require surgical intervention. Most cases of disc extrusion require surgery because the extrusion leads to spinal stenosis, compressing all or part of the blood vessels, and it can also compress the spine and nerve roots, causing irreversible damage, and medications or massages can't reverse the condition. The fourth point concerns lumbar disc prolapse, meaning the nucleus pulposus falls into the spinal canal through the tear. This is one of the few emergencies seen in spinal surgery. If this occurs, immediate surgical treatment is necessary. Therefore, the severity of lumbar disc herniation mainly depends on the type and degree of the herniation, as well as the location and direction of the herniation, and which treatment method needs to be used.

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Written by Na Hong Wei
Orthopedics
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Where to apply moxibustion for lumbar disc herniation

If moxibustion is used to treat a lumbar disc herniation, the main acupoint is the Jiaji acupoint located on both sides of the herniated disc, along with the Jiaji acupoints immediately above and below it. For example, if you have a herniation between the 3rd and 4th lumbar discs, you should moxibust the 2nd, 3rd, and 4th Jiaji acupoints, and so on. In addition to the main acupoint, there are auxiliary acupoints chosen based on the different symptoms of different patients. Generally, if there is significant back pain, the acupoint on the affected side is the Yaoyan. If there is muscle tension and tenderness in the buttocks, match with Huanjiao and Yibian. If there is muscle tension on the back of the thigh, match with Chengfu, Yinmen, and Weizhong. If there is numbness on the outer side of the thigh, match with Fengshi, and for calf numbness, match with Weiyang, Chengshan, and Yanglingquan. If there is numbness on the top of the foot, followed by weakness in the foot or toe region, match with Taixi, Jiexi, and Xiexi.