This is the third edition of the Lumbar Disc Herniation Clinical Practice Guidelines, succeeding the first and second editions published in June 2005 and July 2011, respectively.

Fourteen members selected from various regions of Japan and representatives of the Japanese Orthopaedic Association secretariat, the International Medical Information Center, and Nankodo Co., Ltd. participated in the kick-off meeting held on July 2, 2018 in the Japanese Orthopaedic Association secretariat meeting room. Decisions made were to search the MEDLINE, ICHUSHI, and Cochrane Reviews databases for new articles in ~10 years from January 2008 and analyze them in the following five areas: epidemiology/ natural course, pathological condition, diagnosis, treatment, and prognosis. At the first meeting, on August 11, 2018, Professor Masahiro Yoshida from Minds was invited and delivered a lecture, and the revision work finally started. In the epidemiology/natural course and pathological condition areas, four and five Back ground question (BQ)s were determined, respectively; these were developed based on the Questions in the second edition. While the diagnosis area was subdivided in the second edition, four BQs related to symptoms, diagnostics, diagnostic imaging, and other imaging/auxiliary diagnosis methodologies were determined. In the treatment area, three BQs, four Clinical question (CQ)s, and one Future research question (FRQ) were determined to cover advances after the second edition was published, such as advent of drugs for neuropathic pain and intradiscal treatment and wider use of endoscopic surgery; in the prognosis area, seven BQs were determined after examination of factors affecting the likelihood of return to work/sport, surgery results, and postoperative course. This edition is a product of many and long discussions among revision committee members to prepare guidelines that facilitate the current Japanese medical system to reflect facts based on scientific evidence supported by the latest knowledge collected from a large number of articles, and that are beneficial for healthcare professionals and patients. We hope that this edition of the guidelines finds effective use in various clinical settings.

这是第三版《腰椎间盘突出症临床实践指南》，分别继2005年6月和2011年7月出版的第一版和第二版之后。

从日本各地区选出的14名成员以及日本骨科协会秘书处、国际医学信息中心和南科多株式会社的代表参加了2018年7月2日在日本骨科协会秘书处会议室举行的启动会议。做出的决定是检索MEDLINE、ICHUSHI和Cochrane Reviews数据库中2008年1月以来~10年的新文章，并在以下5个领域对其进行分析：流行病学/自然病程、病理状态、诊断、治疗和预后。在第一次会议上，2018年8月11日，来自Minds的Masahiro Yoshida教授应邀演讲，修订工作终于开始。在流行病学/自然病程和病理状态领域，分别确定了4个和5个背景问题（BQ）；这些是基于第二版中的问题开发的。虽然在第二版中对诊断区域进行了细分，但确定了与症状、诊断、诊断成像和其他成像/辅助诊断方法相关的4个BQ。在治疗领域，确定了3个BQ、4个临床问题（CQ）和1个未来研究问题（FRQ），以涵盖第二版出版后的进展，如神经性疼痛和椎间盘内治疗药物的出现以及内镜手术的更广泛使用；在预后领域，在检查影响恢复工作/运动的可能性、手术结果和术后病程的因素后确定了7个BQ。该版本是修订委员会成员多次长时间讨论的产物，旨在编写指南，促进当前日本医疗系统根据从大量文章中收集的最新知识支持的科学证据反映事实，并对医疗保健专业人员和患者有益。我们希望本版指南能在各种临床环境中有效使用。