1. Overview Intervertebral foramenoscope is similar to spinal endoscope, it is a tube equipped with light, which enters into the intervertebral foramen from the side or the side and back of the patient’s body (it can be flat or diagonal way), and carries out the surgery in the safe working triangle. Surgery is performed outside the annulus fibrosus of the intervertebral disc, where the protruding nucleus pulposus, nerve roots, dural sac, and proliferating bone tissue can be clearly seen under direct endoscopic vision. Then various types of grasping forceps are used to remove the protruding tissues, microscope to remove the bone, and radiofrequency electrodes to repair the broken annulus fibrosus. Our intervertebral foramenoscopy nucleus pulposus removal surgery truly realizes the gold standard of the treatment of spinal diseases, which is the trinity of removal—repair—anti-inflammation. 2.Therapeutic Principle Intervertebral foraminoscopy can completely remove the protruding or prolapsed nucleus pulposus and hyperplastic bone outside the intervertebral foramen safety triangle and intervertebral disc fibrous ring to relieve the pressure on the nerve root and eliminate the pain due to the compression of the nerves, and the surgical method is a minimally invasive surgical system for the spine, which is composed of a specially-designed intervertebral foramen mirror and corresponding matching minimally invasive spinal surgical instruments, imaging and image processing systems. system. While completely removing the protruding or prolapsed nucleus pulposus, it also removes osteophytes, treats spinal stenosis, and can use radiofrequency technology to repair the broken annulus fibrosus. Adapted to the crowd 1, persistent or recurrent radicular pain; 2, radicular pain is heavier than lumbago; 3, ineffective after strict conservative treatment. Including the use of steroidal or non-steroidal anti-inflammatory painkillers, physical therapy, homework or conditional training procedures, it is recommended that at least 4-6 weeks of conservative treatment, but if there is a progressive aggravation of neurological symptoms, then immediate surgery is required; 4, no history of substance abuse and psychological disorders; 5, a positive straight-leg raising test, bending difficulty; 6, in order to accurately determine the location and nature of protruding or prolapsing nuclei, as well as intervertebral foraminal bone proliferation In order to accurately determine the location and nature of the herniated or prolapsed nucleus pulposus, as well as the osteophytes of the intervertebral foramina, a thorough imaging examination should be performed before the surgery. Step 1: marking and puncture localization; Step 2: local anesthesia; Step 3: discography; Step 3: direct insertion of guide wires and guide rods; Step 4: placement of guide rods, catheters, and reaming drills; Step 5: reaming drills are used to form the foramen magnum in each step; Step 6: placement of working trocars and endoscopes; Step 7: use of various types of grasping forceps to remove herniated tissues and microscopic reaming drills. Step 7: use various types of grasping forceps to remove the protruding tissues, microscopic reaming drill to remove the bone, and radiofrequency electrode to seal the broken annulus fibrosus; Step 8: exposure of the vertebral canal or nerves is an important anatomical landmark of the end of the surgery. 5, seven advantages Intervertebral foramenoscopy spine minimally invasive technology aims to operate outside the intervertebral disc fibrous ring, completely remove the protruding or prolapsed nucleus pulposus and hyperplastic bone to relieve the pressure on the nerve root to eliminate the pain due to the pressure on the nerves. The surgery is performed under local anesthesia, and there is no need to fast or drink before the surgery. During the surgery, the patient is conscious and can communicate with the surgeon about his or her feelings during the surgery. In addition, the intervertebral foraminoscopy system enters from one side of the lumbar spine and utilizes the natural channels of the human skeletal structure, so there is no need to remove bones or ligaments, and there is no damage or disruption of the stabilizing structure of the patient’s lumbar spine. Normally, patients can get out of bed 2 hours after the surgery. In terms of surgical trauma, as the intervertebral foramenoscopy surgery is completed under the mirror operation, there is only a 7 mm tiny incision on the skin, bleeding is extremely low, which can completely achieve the effect of open surgery, and it also avoids the big damage, bleeding and expensive internal fixation materials of traditional open surgery. Advantage 1: Safe and green The target area is reached through lateral approach, avoiding the interference of traditional posterior surgery on the spinal canal and nerves, not biting off the vertebral plate, not destroying the paravertebral muscles and ligaments, and having no effect on the stability of the spine. Advantage 2: Repair function Multi-angle bipolar radiofrequency electrode can directly ablate the nucleus pulposus and repair the ruptured annulus fibrosus under low temperature. Advantage 3: Direct purpose Accurately removing the protruding nucleus pulposus under the microscope, the surgical effect is consistent with the gold standard of intervertebral disc surgery – microscopic discectomy. Advantage 4: Wide range of indications It can deal with almost all types of herniated discs, part of spinal stenosis, intervertebral foraminal stenosis, calcification and other bony lesions. The use of special radiofrequency electrodes under the speculum can shape the annulus fibrosus and block the annular nerve branches, treating discogenic pain. Advantage 5: Low complication Intraoperatively, it can eliminate the edema and aseptic inflammation of the nerve root, prevent postoperative infection outside the disc, with small trauma, low chance of forming thrombus and infection, and postoperatively, it won’t leave scar at the important structures in the back and cause adhesion of the vertebral canal and nerves. Advantage 6: High safety Local anesthesia, can interact with the patient during the operation, does not hurt the nerves and blood vessels, basically no bleeding, clear surgical field of vision, greatly reducing the risk of misuse. Advantage 7: Rapid recovery You can go down to the ground the next day after the operation, and resume normal work and physical exercise in 3-6 weeks on average. Intervertebral foramenoscopy can be operated in both posterior and lateral ways to reach the prominent lesion directly. The 3.9mm inner diameter of the channel makes it simpler and more flexible to remove the protruding nucleus pulposus accurately under the visualization, and the outer diameter of the instrument of only 5.5mm avoids blind perforation of the intervertebral foramenoscopy ring saw, and at the same time, it can directly remove the central protruding nucleus pulposus of the lumbar 5-sacrum 1 in the posterior intervertebral space approach. The lateral intervertebral foraminal approach can remove the herniated nucleus pulposus without cutting the muscle fibers, and can reach the herniated part of the intervertebral disc directly through the safe triangular puncture route, which makes the operation more direct and convenient. It avoids the disadvantages of traditional surgery that interferes with the spinal canal and nerve roots, bites off the vertebral plate, destroys the paraspinal muscles and ligaments and affects the stability of the spinal column, and the unique bipolar radiofrequency of the device can complete hemostasis and repair of the broken annulus fibrosus after the herniated nucleus pulposus has been removed, which avoids the disadvantage that the posterior microscope surgery has to be stopped due to intraoperative bleeding and prevents the postoperative infection, thus really realizing the three-in-one operation: removal – repair – anti-inflammation. -Repairing and anti-inflammation is the gold standard of spinal disease treatment.