We often encounter patients in the clinic who ask, “I have already had a CT and am sure I have a herniated disc, why do I need to have another one? Now we will briefly understand the difference between the various imaging examinations so that we can have a better understanding. The lumbar spine frontal and lateral X-ray is the most traditional imaging method with low cost and easy operation and implementation, which provides a general understanding of the patient’s lumbar region and can guide the next step of examination and treatment. It has good diagnostic value for fractures, slipped dislocations, degenerative growths and scoliosis. In addition, lumbar spine radiographs in special positions, such as double oblique position and hyperextension and hyperflexion position, can detect diseases such as isthmus fracture and lumbar spine slippage that the patient feels discomfort only when changing position. It can also guide the physician in determining whether this patient is amenable to minimally invasive surgical treatment. It is rarely possible to use MRI as a substitute for X-ray. CT examination of the lumbar spine is significantly better than X-ray in terms of horizontal cross-section, especially in terms of clear visualization of bone tissue, which is conducive to measuring the distance between bony structures, but is not as clear and high resolution for soft tissue visualization. Patients with calcification require special equipment for our intraoperative management. If a patient has a herniated disc with calcification formation then CT can be very good for us to visualize it and thus guide how to proceed with the surgery. CT + 3D reconstruction of the lumbar spine helps to show the general structural changes of the spine and fractures in three dimensions. However, CT scans are limited to the interval of the scan level and cannot read the information of the examined area as a whole, which leads to a certain rate of missed diagnosis such as whether there is free disc herniation, etc., which cannot be well observed. The biggest difference between lumbar magnetic resonance imaging (MRI) and X-ray and CT examinations is that there is no X-ray radiation during the examination, which causes minimal damage to the body and is relatively expensive. It is mainly used to detect soft tissue diseases and can help doctors to find disc lesions, spinal cord lesions, inflammatory lesions and tumor lesions. Early detection of vertebral fractures, spinal tuberculosis, spinal tumors, etc. It allows clear visualization of the herniated disc nucleus pulposus and pathological staging to guide treatment and surgical implementation. However, MRI has its drawbacks. MRI is not as accurate as CT for bone tissue; dynamic MRI is tens of times more expensive than dynamic X-rays; and the choice of surgical treatment is an important one for every patient, perhaps once in a lifetime. Therefore, in order to better diagnose the patient’s disease, choose the treatment plan, determine the specific implementation of the operation, and minimize the risk borne by the patient. We need all three certificates before minimally invasive surgery to avoid misdiagnosis and omission that may cause unnecessary loss to the patient.