OBJECTIVE: To retrospectively analyze the clinical data of patients who were clinically diagnosed with lumbar disc herniation and treated with simple nucleus pulposus removal surgery, and the clinical data of nucleus pulposus reherniation in the original surgical space within 2 years after surgery, so as to provide reference for careful analysis of clinical data to reduce the occurrence of lumbar disc surgery failure syndrome during phase I surgery. METHODS: We analyzed the clinical manifestations of 63 patients with lumbar disc herniation who underwent simple nucleus pulposus removal in our department from 1995 to 2005, and the clinical data and surgical methods of the patients at the time of the first operation, among the total 63 cases, 41 were male and 22 were female. Of the total 63 cases, 41 were male and 22 were female. 9 cases had their first surgery in our department and 54 cases had their first surgery in an outside hospital. Twenty-one cases were operated with discoscopy and small openings, and 42 cases were operated with half and full laminae. There were 51 cases of single-space surgery and 12 cases of two or more spaces. Results: 17 patients were cured by simple nucleus pulposus at the time of reoperation, 41 patients underwent posterior decompression nucleus pulposus extraction with pedicle screwing and internal fixation with bone grafting and fusion (PLIF), and 5 patients underwent transtentorial nucleus pulposus extraction with pedicle screwing and internal fixation with bone grafting and fusion (TLIF). All cases were cured after secondary surgery. Conclusion: Re-protrusion after surgery for lumbar disc herniation is a common clinical problem that can occur in both early and late stages. Reasonable selection of surgical indications and appropriate surgical approach can help reduce the occurrence of re-protrusion, and clinical cure can be obtained with secondary surgery. Keywords: Lumbar disc herniation is a common clinical lesion, and there has been extensive and in-depth research on this disease for a long time, and simple nucleus pulposus removal is an effective treatment method for this disease, but due to certain limitations in the early understanding of this disease, the performance of lumbar disc herniation surgery failure syndrome occurs during the treatment of this disease, and the re-herniation of the nucleus pulposus in the original interspace is a failure syndrome after surgery. This paper analyzes the clinical findings of patients before and after surgery. In this paper, we analyze the clinical data of patients before and after surgery, and hope to provide help for the clinical treatment of initial lumbar disc herniation. 1, Clinical data 1.1 General data From 1995 to 2005, 63 patients with lumbar disc herniation who underwent simple nucleus pulposus removal surgery were admitted to our department, among them, 41 were male and 22 were female, aged from 24 to 54 years old, with an average of 41 years old. The first operation was performed in our department in 9 cases, and the first operation was performed in a foreign hospital in 54 cases. 1.2 Selection of surgical methods: 21 cases underwent posterior discoscopy and small opening surgery, 42 cases underwent hemivertebral plate and full plate surgery. There were 51 cases of single-space surgery and 12 cases of two or more spaces. 1.3 Time of re-protrusion: 17 cases with re-protrusion of the original interspace within six months after surgery, 46 cases with re-protrusion of the original interspace within 2 years. 1.4 Selection of secondary surgery: 17 patients underwent total laminectomy decompression and nucleus pulposus removal, 41 patients underwent posterior decompression nucleus pulposus removal with internal fixation and implant fusion (PLIF), and 5 patients underwent transpedicular root nucleus pulposus removal with internal fixation and implant fusion (TLIF). The analysis of the preoperative imaging data of patients with disc herniation revealed that 37 patients in this group had lumbar instability on the preoperative X-ray, which was characterized by an angular difference of more than 15 degrees between the herniated gaps on the lateral X-ray in hyperextension and hyperflexion. No significant lumbar spine osteophytes were seen in the preoperative imaging data of this group of patients. The postoperative imaging data showed that 37 patients who had lumbar instability before surgery showed further aggravation of instability on postoperative lumbar hyperextension and hyperflexion X-rays, and 3 patients showed lumbar slippage. The postoperative imaging of patients in the small open surgery group showed serious damage to the small joints on the open side of the lumbar spine during the opening, and the patients showed instability of one side of the lumbar spine. The rest of the patients did not show lumbar instability. All of the above patients with secondary disc herniation were treated with reoperation because of obvious neurological compression. 17 patients were cured by simple nucleus pulposus removal, 41 patients were treated with posterior decompression nucleus pulposus removal with pedicle screwing and implant fusion (PLIF), and 5 patients were treated with transcatheter foraminal nucleus pulposus removal with pedicle screwing and implant fusion (TLIF). In all cases, the symptoms and signs were significantly relieved after the second operation, and no recurrence was observed at 1-5 years of follow-up. The imaging of the patients in the implant fusion group showed good intervertebral fusion, and the patients in the group without intervertebral fusion did not show any significant secondary lumbar instability changes, nor were they left with chronic low back pain. 4, discussion of lumbar disc herniation is a very common clinical disease, treatment is difficult, there is not yet an effective can be applied to all types of disc herniation of the special method, therefore, around the treatment of this disease international and domestic treatment methods are many. In general, there are three main categories of treatment: conservative treatment or non-surgical treatment, non-fusion surgical treatment, and intervertebral fusion surgical treatment. Recurrence of disc herniation after surgery occurs only in the category of non-fusion surgical treatment, mainly because the purpose of surgery is limited to removing the nucleus pulposus tissue that compresses the nerve roots and dural sac. Most of the disc remains in the fibrocartilage discs of the intervertebral space. In the early period when there was a lack of systematic understanding of the disc structure, people did not have an objective understanding of the degenerative process of the disc because they only saw the influence of the nucleus pulposus on the local compression of the herniated disc, and surgery only removed the nucleus pulposus in the herniated spinal canal without any intervention on the disc tissue in the intervertebral space. In view of this situation, some authors, by observing the disc structure of cadaveric tissue and measuring the quality of the disc, concluded that postoperative recurrence was mainly caused by incomplete removal of the nucleus pulposus, and therefore recommended that all nucleus pulposus tissue within the intervertebral space be completely removed during surgery, and even recommended that the removed nucleus pulposus be weighed after removal to ensure complete removal, thus resulting in Some surgeons used scrapers to remove the nucleus pulposus and fibrocartilage discs after surgery to remove the nucleus pulposus, and this method is still used in some hospitals. This method is still used in some hospitals. However, after this, some authors found after long-term follow-up that it may cause rapid reduction of the intervertebral space height, secondary to severe spinal stenosis or lumbar instability, which led to a great debate on the method of surgical treatment of lumbar discs. This has led to the emergence of the now widely popular technique of disc removal with intervertebral fusion. The rise and fall of the surgical procedure reflects the process of understanding this disease, along with the development of the theory of disc structure and spinal biomechanics, the development of disc herniation is gradually more rationalized, and the surgeon’s comprehensive consideration of the function of the disc itself and the stability of the lumbar spine has led to the emergence of the current treatment of disc herniation is no longer the single surgical approach of the past. Surgical procedures for herniated discs are currently being performed: minimally invasive procedures such as papainolysis of the nucleus pulposus, laser or microwave radiofrequency ablation, various discoscopic nucleus pulposus removal procedures; traditional nucleus pulposus removal procedures such as small open window nucleus pulposus removal, hemi-laminectomy nucleus pulposus removal, total laminectomy nucleus pulposus removal, etc.; disc removal intervertebral fusion procedures such as anterior disc removal implant fusion, posterior disc removal fusion, etc. The emergence of these methods also reflects the need for a better understanding of the intervertebral disc and the need for a better understanding of the intervertebral disc. The emergence of these methods also reflects an understanding of the structure of the spine, and each surgical approach is somewhat exclusive, so the surgeon should have a full understanding of each surgical approach and each patient’s situation to ensure that the patient receives the most reasonable treatment. The 63 patients reported in this paper also reflect the limitations of some surgeons in their understanding of the disease and in their knowledge of the procedure. Minimally invasive or minimally invasive surgery is not appropriate in all cases and cannot be performed at the expense of the small joint in order to preserve the spinous process and lamina. In cases where extensive spinal decompression is required and a certain amount of the vertebral tuberosity must be removed during surgery, this should be complemented by procedures to stabilize the spinal structures such as interbody fusion. Preoperative determination of spinal stability is the key to successful surgery. In this group of cases, patients with preoperative lumbar instability experienced an increase in lumbar instability and an early recurrence of postoperative disc herniation. Although most of the patients did not show a direct correlation with recurrence of disc herniation, some authors believe that premature dismounting, on the one hand, may cause the hematoma to be extruded into the spinal canal because of the accumulation of blood in the cavity after disc removal, and on the other hand, the nucleus pulposus left in the disc may be further extruded into the spinal canal, causing On the other hand, the nucleus pulposus left in the disc may be further extruded into the spinal canal, causing early recurrence of disc herniation after surgery, because we know that the purpose of disc herniation surgery is only to remove the nucleus pulposus that is extruded to the nerve roots or dura, and it is impossible and unnecessary to remove all the disc tissue, and complete disc removal may lead to a significant reduction of the vertebral space and cause nerve root compression, so the complete removal of the disc should be accompanied by intervertebral implant fusion and internal fixation. In summary, we believe that for patients with different types of lumbar disc herniation, a comprehensive analysis and assessment of the patient’s condition should be made before surgery, and surgery is not based on the principle of pursuing minimally invasive and small openings. Although the surgery is large and expensive, the complications and recurrences are minimal, and it is undoubtedly one of the proven methods. It is generally recommended to start the procedure three weeks after surgery, i.e. after soft tissue repair, to reduce the chance of recurrence.