Lumbar disc herniation is currently a common cause and common disease causing lumbar and leg pain, often causing great physical and mental pain to the patients and a decrease in their ability to work in life. Although in recent years, some minimally invasive interventional techniques such as laser vaporization and ozone disc melting have been used to treat lumbar disc herniation, the efficacy is not exact, or recurrence may occur soon, which brings great physical torture and economic burden to patients. In recent years, our hospital has been using the “foraminoscopy technology” to treat herniated discs, and has achieved very good results. In summary, the “foraminoscopy technology” has the characteristics of “minimal trauma, little pain, good efficacy, fast functional recovery and high cure rate”. Minimally invasive foraminoscopic spine technology represents a new concept of minimally invasive spine surgery. Because of its many advantages, the international field of minimally invasive spine surgery has now recognized the dominance of foraminoscopy in the field. 1, the basic principle With the development and maturation of the spinal endoscopic transvertebral foraminal approach and its application, the application of Thessys technology is gradually accepted and has become the mainstream method of intervertebral foraminal technology. The basic principle of its operation: Its purpose is to remove the pressure on the nerve root and eliminate the pain caused by nerve compression by completely removing the herniated or prolapsed nucleus pulposus and hyperplastic bone in the safety triangle of the intervertebral foramen, outside the intervertebral disc fibrous ring. The procedure is performed through a minimally invasive spinal surgery system with intervertebral foraminoscopy and corresponding surgical instruments, imaging processing system, and Ellman dual-frequency radiofrequency machine. While completely removing the herniated or prolapsed nucleus pulposus, it removes osteophytes, treats spinal stenosis, and can repair the broken ring using radiofrequency technology. 2.Surgical method In order to precisely determine the location and nature of the herniated nucleus pulposus and the condition of the osteophytes in the intervertebral foramen, a thorough clinical and neuroorthopedic examination should be performed before surgery. Imaging, especially MRI, is an important tool to accurately determine the size, location and nature of the nucleus pulposus. The final diagnosis is confirmed by discography. Appropriate patient positioning and precise design of the approach are critical to the outcome of the procedure. Intervertebral foraminoscopy combines the approach and technique to perform all disc nucleus pulposus removal, fibrous annuloplasty, and removal of osteophytes from the cervical spine to lumbar 5 sacral 1. Any herniated or even free nucleus pulposus tissue can be removed through this system. The special way to reach the herniated disc using this method is through the intervertebral foramen safety triangle. In the case of a prolapsed disc, the foramen is usually narrowed significantly, requiring the removal of the dislodged nucleus pulposus tissue by grinding and drilling the scope, using specially developed biting forceps, graspers, etc. 3. Technical advantages For a long time, laminectomy and lumbar disc removal were the only surgical treatments for patients with severe disc herniation. Due to the lack of good specific diagnostic methods and treatments, physicians continued to offer a wide variety of physical therapies to patients depending on their condition. In the face of new surgical treatments, some conservative physicians remain stubbornly committed to their old views as they await scientific proof of the new therapies. To date, conservative treatments are the only ones that have not been challenged. However, as a viable new technology and approach, the “gray area” treatment, which can reduce pain and provide better specificity in diagnosis, is a bridge between conservative and surgical treatment. Minimally invasive intervertebral foraminoscopic spine technology is a well-established and proven technique that has only been introduced to the world by the famous German surgeon. It has some major advantages as follows: (1) Wide range of indications: it can deal with almost all types of disc herniation, some spinal stenosis foraminal stenosis, calcification and other bony lesions. With the use of special radiofrequency electrodes under the scope, fibrous annuloplasty and sinus nerve branch discogenic pain are feasible. (2) Through the lateral approach to directly reach the location of the lesion, avoiding the interference of posterior surgery on the spinal canal, without biting off the vertebral plate, without destroying the paravertebral muscles and ligaments, and without adhesions to the stability of the spine. It can also prevent postoperative segmental instability and slippage (3) High safety, the patient only needs local anesthesia, and the patient’s reaction can be observed at any time during surgery. (4) Less traumatic complications, with minimal risk of nerve injury and thrombosis. (5) The skin incision is only 7 mm, and the recovery is fast, and the patient can go to the floor the next day after the operation, and return to normal work and physical exercise in an average of 3-6 weeks. (6) High patient satisfaction, high comfort level, immediate pain relief, mild postoperative pain, self-care of urine and stool, and easy care. (7) The Ellman radiofrequency electrode pair used at the same time can protect the integrity of the fibrous ring and posterior longitudinal ligament, thus reducing the recurrence rate of postoperative disc herniation. The calcified disc can be removed at the same time; the specially designed bipolar radiofrequency electrode can perform good hemostasis and fibrous annulus repair molding in disc surgery. (8) Published international literature has reported success rates of more than 90% at 1 and 2 years postoperative follow-up, with early recurrence rates of less than 5%. Among patients with open surgery recurrence, the success rate exceeds 84%. 4.Technology comparison Minimally invasive technology is inevitably the development direction of surgery. However, the surgical access and treatment process of posterior discoscopy are consistent with small-incision open surgery, which requires epidural anesthesia, laminar opening, stripping of muscles and ligaments, interference with the spinal canal, pulling nerves, easily causing intraoperative bleeding, disturbing the visual field and increasing the risk; it cannot be applied to the treatment of extreme lateral herniation and discogenic pain; the postoperative scar tissue is likely to cause adhesions of the spinal canal and nerves, and it is also very difficult to remedy the surgery again. The postoperative scar tissue is likely to cause adhesions to the spinal canal and nerves, and re-remediation is very difficult. The foraminoscopic technique can treat all types of disc herniations in the thoracolumbar segment, allowing not only direct removal of the herniated tissue but also, if necessary, removal of the entire disc for fusion and fixation. The core of this minimally invasive technique is that it does not pass through the posterior approach, leaving no scarring in the posterior after surgery and causing no adhesions to the spinal canal or nerves. Even if the surgery fails, a further posterior procedure looks from the posterior as if no surgery had been performed. The equipment used not only completes minimally invasive surgery, but also takes into account the needs of some pain management areas. For example, the radiofrequency machine used in this system can do “radiofrequency ablation”, i.e. IDET, which is mainly used for nerve destruction of discogenic pain and parallel fibroplasty, and if necessary, it can also do intra-disc nucleus pulposus ablation and part of target ablation treatment. 5, lumbar disc herniation misconceptions Domestic treatment and diagnosis of lumbar disc herniation have reached a high level, but because the symptoms of lumbar disc herniation easily confuse patients and doctors, so there are many misconceptions in diagnosis and treatment, and many people even believe that lumbar disc herniation is an incurable disease, so what are the misconceptions in the treatment of lumbar disc herniation? Myth 1: Low back pain is not considered a disease. A survey has shown that more than 95% of people have suffered from low back pain in their lifetime. Some of the primary diseases of low back pain are cured, and the pain ceases to exist. There are also some that do not heal themselves. Therefore, some patients think that low back and leg pain is not a disease. In fact, low back and leg pain caused by lumbar disc herniation is not only a disease, but also needs to be paid great attention to. Because this disease can cause not only low back and leg pain, but also lower limb numbness, weakness, and even paralysis and other disorders, seriously affecting the health problems of life. Myth 2: Low back and leg pain can’t be cured The characteristic of lumbar disc herniation is that it is easy to recur. Therefore, some patients and even some doctors think that lumbar disc herniation cannot be cured. In fact, the overall effect of lumbar disc herniation treatment is very good, about 90% or more effective. The so-called cure is not good for two reasons: one is the choice of improper method, the second is not adhere to the treatment. Some patients go to where they hear that there is a new treatment, where they go as long as they do not operate, but where they can not adhere to, and ultimately is running a lot of places, but the effect is not very satisfactory. Myth 3: Blind surgery or refusal to operate On the issue of surgery, patients generally have two very different opinions: one is blind surgery, and the other is refusal to operate. The former believes that only surgery can cure lumbar disc herniation, in fact, the indications for lumbar disc herniation surgery are very strict, but surgery is not the first choice for the treatment of lumbar disc herniation; the latter further expands the negative effects of surgery, such as nerve damage, and believes that surgery must not be done and conservative treatment is used. In fact, most patients with lumbar disc herniation can be cured by minimally invasive intervention (a latest method between surgery and non-surgery), with a one-time treatment time of only 3~5 minutes, so minimally invasive intervention has become the best choice for most lumbar disc herniation indications today. 6. Advantages of intervertebral foramoscopy technology in minimally invasive spine surgery (1) Intervertebral foramoscopy technology is similar to spinal endoscopy in that it is a tube equipped with a light that enters the intervertebral foramen from the side or side and back of the patient’s body to perform surgery in the safety triangle. (2) Foraminoscopy removes pressure on the nerve root by completely removing the herniated or prolapsed nucleus pulposus and hyperplastic bone outside the foramen’s safety triangle, outside the disc’s fibrous annulus, to eliminate pain. (3) The selection criteria for foraminoscopic disc removal are not fundamentally different from those for laminectomy and disc removal. (4) Clinical advantages of foraminoscopic orthopedics: in 2010, many patients with lumbar disc herniation have been successfully implemented disc nucleus pulposus removal surgery in China, achieving reliable results, immediate relief of patients’ pain, and short-term return to normal work after surgery. (5) Intervertebral foraminoscopic technique: removal of herniated disc tissue under endoscopic surveillance is less traumatic than the usual posterior surgery, and radiofrequency fibrous ring repair can be performed at the same time. (6) Compared with the posterior discoscopy technique, intervertebral foramoscopy has obvious advantages such as less trauma, less bleeding, easier anesthesia, faster postoperative recovery and less economic burden, etc. 7. The procedure is performed in the triangle. The procedure is performed outside the disc annulus fibrosus, and the herniated nucleus pulposus, nerve roots, dural sac and hyperplastic bone tissue can be clearly seen under direct endoscopic vision. The herniated tissue is then removed using various types of grasping forceps, the bone is removed microscopically, and the broken fibrous annulus is repaired with radiofrequency electrodes. The surgical trauma is small: the skin incision is only 7mm, like the size of a soybean grain, bleeding is less than 20ml, and only one stitch is needed after the operation. It is the minimally invasive treatment for disc herniation with the least trauma and the best effect among similar surgeries. 8, intervertebral foramoscopy technology treatment principle: intervertebral foramoscopy through the intervertebral foramen safety triangle, outside the intervertebral disc fiber ring, completely remove the herniated or prolapsed nucleus pulposus and proliferated bone to release the pressure on the nerve root, eliminate the pain caused by the nerve compression, its surgical method is through the specially designed intervertebral foramoscope and the corresponding supporting minimally invasive spinal surgical instruments, imaging and image processing system, etc. together to form A minimally invasive spine surgery system. While completely removing the herniated or prolapsed nucleus pulposus, it also removes osteophytes, treats spinal stenosis, and can repair broken annulus fibrosus using radiofrequency technology. 9, intervertebral foraminoscopy technology compared with other orthopedic treatment methods: It is understood that this technology removes herniated disc tissue under endoscopic surveillance through a special lateral intervertebral foramen approach, which is less invasive than the usual posterior surgery. Typical laminectomy in order to approach the target point necessarily causes extensive damage to structures that play an important role in spinal stability, which usually requires immediate spinal fusion. In contrast, the laminectomy technique gradually enlarges the intervertebral foramen with a patented reamer and appropriate medical instrumentation, completely removing any herniated or prolapsed fragments as well as the degenerated inflamed nucleus pulposus. It also allows for continuous irrigation and decontamination of the lesion, repair of the annulus fibrosus using radiofrequency electrodes, ablation of nerve sensitizing tissue, and blockage of the annular nerve branches, relieving the patient of soft tissue pain.