High lumbar disc herniation refers to the herniation of lumbar 1/lumbar 2, lumbar 2/lumbar 3 and lumbar 3/lumbar 4 discs. The incidence is about 5%, with lumbar 3/lumbar 4 disc herniation being the predominant one. More than half of the cases have a history of trauma, and those who have undergone previous low lumbar disc surgery may be induced to develop high lumbar disc herniation. The main clinical manifestations of high lumbar disc herniation are: 1. most patients have low back pain, lower back pain, but generally radicular pain is not obvious; 2. anterolateral thigh pain, hyperalgesia in front of the thigh, quadriceps atrophy, positive femoral nerve pull test, weakened knee reflex, paraplegia may occur in some cases of lumbar 1, 2 or lumbar 2, 3 disc herniation, paraplegia may occur suddenly, myelogram obstruction in lumbar 2, lumbar 3 plane. In 3 and 4 lumbar disc herniation, radicular pain may occur, manifesting as typical sciatica, with positive straight leg raise test and positive thigh posterior extension test. The diagnosis of high lumbar disc herniation can generally be made initially through medical history and physical examination, but its definitive diagnosis often requires further imaging. Since high lumbar disc herniation is most frequent in lumbar 3 and lumbar 4, 50% of patients have loss of knee reflex. No reflex changes were found in lumbar l/ lumbar 2 disc herniation. Thigh muscle atrophy was more pronounced than calf. The muscle changes were listed in order of multiplicity: quadriceps, extensor digitorum longus, iliopsoas, and gluteus maximus, indicating nerve root involvement of lumbar 1 to lumbar 4. Non-surgical treatment can be used for mild cases. However, surgical treatment should be performed for recurrent episodes with obvious manifestations of nerve damage. Posterior hemivertebral laminectomy or total laminectomy is preferred for extraperitoneal removal of the herniated material. In cases of lumbar 1/2 disc herniation. Care should be taken not to damage the spinal cord during surgery.