Surgery for lumbar disc herniation is a more common and effective treatment for lumbar disc herniation. Surgery can eliminate the protrusions that compress the spinal nerve and other surrounding tissues more completely, and fundamentally relieve the clinical symptoms of the back and legs. So which lumbar disc herniation should be treated by surgical therapy? (1) Those with heavy symptoms that affect life and work and are not treated by non-surgical therapy; or those with severe symptoms that cannot be treated by non-surgical therapy such as traction and massage. (2) Patients with extensive muscle paralysis, sensory loss and damage to the cauda equina (e.g., loss of sensation in the saddle area and urinary and fecal dysfunction), and those with complete or partial paraplegia. Most of these patients have a central protrusion, or a ruptured nucleus pulposus that has broken off into the spinal canal, resulting in extensive compression of the nerve roots and cauda equina, and should be operated as soon as possible. (3) Patients with severe intermittent claudication and spinal stenosis at the same time, or those with spinal stenosis on X-ray and CT images, for which non-surgical treatment is not effective, should undergo surgery as early as possible. (4) In cases of combined lumbar isthmus discontinuity and spinal slippage, surgical removal of the diseased nucleus pulposus tissue and simultaneous fusion of the contralateral vertebral plate and interspinous bone graft are recommended. (5) For young and middle-aged patients with recurrent attacks, the indications for surgery may be relaxed in order to restore their working ability as soon as possible. The indications for surgery in elderly and frail patients should be strictly controlled.