Lumbar disc herniation is the most common clinical cause of back and leg pain. Fifteen to twenty percent of our manual workers suffer from this disease. Patients with lumbar disc herniation may exhibit various clinical symptoms depending on age, gender, duration of disease and location of the herniation. In the past, most of the lumbar disc herniations were removed and fused at home and abroad. However, with the progress of medicine, minimally invasive techniques and non-fusion techniques suitable for different conditions have gradually emerged. Minimally invasive techniques undoubtedly offer hope to many patients who are afraid of conventional open surgery when conservative treatment is ineffective. In fact, each spine surgery has its own indications, contraindications and suitable people. Not every patient is effective with conservative treatment, and not all patients are suitable for minimally invasive treatment. The full application of different treatment methods for patients with lumbar disc herniation and the development of individualized graded-step treatment plans can often achieve more satisfactory results than before. Phase I: Conservative treatment 80% of patients can improve with regular conservative treatment. Most patients with lumbar disc herniation can be treated conservatively and find relief. Formal conservative treatment methods include bed rest, traction, physical therapy, closed therapy and oral pain relief. Stage 2: Interventional treatment (this stage of treatment is no longer recommended by major hospitals at home and abroad) For patients who do not respond to conservative treatment after a long period of time (more than 3 months) and are unwilling to undergo surgery, interventional treatment can solve part of the problem. It includes collagenase injection, ozone injection, radiofrequency, laser and plasma knife, etc. In general, patients with mild symptoms, early lesions, MRI or CT examinations suggesting mild herniated lumbar discs, no free and prolapsed discs and no significant segmental instability present, can be treated with percutaneous interventional therapy to achieve the therapeutic goal of relieving spinal cord and nerve compression and irritation. Interventional therapy is less invasive and early to get out of bed, but it is not effective in removing pressure-causing materials, and many cases relapse soon after a short period of relief, and the indications for treatment are narrow. The absolute indications for surgery are damage to the cauda equina and progressive motor dysfunction; the relative indications are patients with ineffective conservative treatment, temporarily effective conservative treatment but with recurrent sciatica, significant motor dysfunction, combined lumbar spinal stenosis, huge disc herniation, severe pain and difficult to relieve in various positions. Surgical methods include minimally invasive foraminoscopic treatment and conventional surgery. (1) Minimally invasive intervertebral foraminoscopic treatment Features (compared with traditional open surgery, surgical efficacy and complications are equal to or even better than traditional open surgery; small skin incision (aesthetic); small muscle damage (light postoperative pain, fast recovery); small impact on bone and joint (small impact on spinal stability); small ligament damage (small impact on postoperative stability); few sequelae, fast postoperative recovery, short hospitalization time, is currently the most It is the most scientific treatment method. It is fundamentally different from interventional treatment in that the nucleus pulposus is removed directly from the spinal canal under visualization using an endoscope, which is safer than open surgery. The procedure is performed under local anesthesia, and the patient can interact with the surgeon during the procedure. The wound is only 7 mm and can be closed without sutures. The herniated disc is removed under direct visualization with video magnification, making the procedure safe and reliable. Immediately after surgery, the patient feels relief from back and leg pain and has a negative straight leg raise test. Because this method is so minimally invasive and allows immediate bedtime activity, we are now gradually adopting day surgery (hospitalization on the day of surgery and discharge the next day). (2) Conventional surgery In the absence of minimally invasive surgery such as intervertebral foraminoscopy, conventional open surgery is still the most effective method for lumbar disc herniation. Conventional surgery includes open interlaminar openings, hemi-laminectomy, total laminectomy and other disc removal procedures, including microsurgery or conventional surgery under direct vision. Stage 4: Non-fusion technique Non-fusion fixation technique for lumbar disc herniation has strict indications and is generally considered to be indicated for patients with mild lumbar instability. Stage 5: fusion technique This is the most mature and most effective method, and is the ultimate treatment for lumbar disc pathology for cases with both lumbar instability and slippage, but at the expense of spinal motion function of the operated segment. In recent years, this procedure has been performed with the aid of minimally invasive access, and is gradually accepted by patients for its less intraoperative bleeding, less postoperative pain, faster recovery (you can get out of bed the day after surgery), and shorter hospital stay than conventional open surgery. The “ladder treatment” of disc herniation is based on various factors such as the patient’s different pathological status, clinical manifestations and the patient’s general condition, and the most suitable treatment method is chosen to relieve symptoms, achieve cure, early recovery and preserve function as much as possible. Different measures are used at different stages to avoid “one-size-fits-all” blind treatment.