Lumbar disc herniation is a common clinical disease and multi-morbidity, and most patients can achieve good results or be cured through conservative treatment with Chinese and Western medicine. However, there are still some patients who need surgery after poor results of systematic conservative treatment. We have concluded some rules through clinical research, and we found that the nature, degree, location, lumbar spine stability, lumbar spinal canal development and other factors of lumbar disc herniation are obviously related to the effect of conservative treatment, and some special types of disc herniation usually need surgery to achieve good results. 1, the nature of lumbar disc herniation – hard herniation (common in patients with disc calcification, epiphyseal dissection, endplate rupture), common lumbar disc herniation is the nucleus pulposus breaking through the annulus fibrosus, its nature is mostly soft, compared with soft herniation, hard herniation has a more significant effect on the nerve apex pressure, soft herniation may be dehydrated over time, the herniation retracts and the compression is reduced, but hard herniation rarely shrinks spontaneously, hard herniation The nerve compression caused by hard herniation persists and often requires surgery to release the compression to achieve good results. 2, the site of lumbar disc herniation – lumbar nerve roots from the spinal canal out through the nerve root canal, nerve root outlet around the bony structure constitutes a bony nerve root canal, where the space is narrow, under normal circumstances enough nerve root travel, when this part of the disc herniation, often resulting in nerve compression, front and back pressure. The more lateral the herniation is, the closer it is to the bony nerve root canal, and the more pronounced the nerve root compression is. Because of the significant nerve root compression, the nerve root cannot be cushioned by conservative treatment, and the effect of conservative treatment is usually poor. 3, lumbar disc prolapse combined with spinal stenosis – the reason is very simple, when the disc prolapse, the nerve compression is greater, nerve compression is difficult to be relieved by conservative treatment, when combined with spinal stenosis, the compression is even more significant, the wide spinal canal provides space for the nerve to escape and give way, once the spinal canal is narrowed, the nerve buffer gives way to space is small, the effect of conservative treatment is not easy to The results of conservative treatment are not easy to achieve. This type often requires surgery. Because this type may lead to cauda equina deformity injury, when conservative treatment is not effective, it is recommended to operate as soon as possible, so as not to delay treatment to aggravate the condition, once the cauda equina is injured, the disability rate is high. 4, lumbar stability – lumbar instability is often caused by the destruction of the bony structure of the lumbar spine or small joint loosening, poor stability of the lumbar spine, it is difficult to rebuild stability through conservative treatment, often requiring surgery.