Introduction Lumbar disc herniation is one of the most common causes of back and leg pain, with a high incidence of more than 15%. It has a great impact on people’s daily life and work. As age increases, the extent of the lesion gradually worsens and will cause a series of more serious symptoms. It is a disease in which the lumbar intervertebral disc degenerates and then, under the action of some external force, the fibrous ring ruptures partially or completely, along with the nucleus pulposus, which expands outward and compresses the nerve roots or spinal cord and other tissues, causing back pain and a series of neurological symptoms. It is also called “lumbar spine fibular ring rupture”. The cause of lumbar disc herniation is generally considered to occur on the basis of disc degeneration, and trauma is often an important cause. It is generally believed that the intervertebral disc begins to degenerate after the age of 20. The water content of the nucleus pulposus gradually decreases, and the elasticity and load resistance of the intervertebral disc also decreases. In daily life, the disc is repeatedly subjected to loads such as extrusion, flexion and torsion, and it is easy to produce fissures from the inside out at the rear of the lumbar disc where the disc is subjected to the greatest stress, i.e., the fibrous ring, and this change is not accumulated but gradually aggravated, and the fissures are increasing, so that the fibrous ring here gradually becomes weak. On this basis, due to a heavy trauma, or repeated mild trauma, or even some daily activities to increase the pressure of the disc, can prompt further rupture of the degenerative and accumulative injury of the annulus fibrosus, the degenerated nucleus pulposus tissue by the weakness of the annulus fibrosus or the rupture protrudes, the injury of the annulus fibrosus itself can cause lumbago, and the protrusion compresses the nerve root or cauda equina nerve, causing lumbago and radiated lower limb pain, as well as symptoms and physical symptoms of neurological impairment. The protrusion compresses the nerve root or cauda equina, causing low back pain and radiating lower limb pain, as well as signs and symptoms of nerve function impairment. In addition, genetic factors, pregnancy, smoking, wind and cold, congenital malformation of the lumbosacral column, and diabetes mellitus (which can accelerate arteriosclerosis, thus causing blood flow and metabolic disorders and accelerating degeneration or protrusion) can all cause or induce this disease. Clinical manifestations Low back pain and radiating pain in the lower extremities: most patients have symptoms of low back pain and sciatica, with pain radiating from the lumbosacral region to the buttocks, posterior and lateral thighs, calves, heels and dorsum of the feet. The pain may be relieved when bending at the waist and hips; it may be aggravated by coughing, sneezing, and stooling. Low back pain decreases at rest and worsens with activity. Most patients cannot walk long distances due to the presence of pain. Numbness: Some patients may feel numbness in the lower legs and feet. Weakening of strength: When the disease is severe, there may be a weakening of the ankle and toes, and it is best to visit a hospital when this occurs. Restricted lumbar movement: Patients with lumbar disc herniation will have less lumbar mobility in all directions, usually more pronounced in the posterior lumbar extension hand line, and, the pain is often aggravated when the lumbar extension is posterior. Cauda equina syndrome: Patients present with alternating left and right sciatica and numbness in the perineal region Severe patients may experience incomplete paralysis of the lower extremities, difficulty with urination and defecation, male patients may develop impotence, female patients develop urinary retention and incontinence, and once cauda equina syndrome develops surgery is often required. Treatment The treatment of lumbar disc herniation is divided into non-surgical treatment and surgical treatment 1. Non-surgical treatment: The incidence of lumbar disc herniation is still increasing and is getting younger, with the youngest of the patients seen being only 12 years old. Although surgery is the most effective way to cure this disease, but because of the strict requirements of the disease surgical indications, lumbar disc herniation patients are mostly conservative treatment, surgery patients less than 1/10 of the number of patients. Non-surgical treatment should be given to the first attack of a short course of disease and symptoms relief after rest, affect the blood test without serious protrusion. 80%-90% of patients can be funded for surgical treatment and healed. There are many conservative treatments for lumbar disc herniation, such as medication, ion leakage, mechanical traction, manual massage, microwave, extracorporeal laser, herbal fumigation, acupuncture, small acupuncture …… With the development of science and technology, the variety is still increasing. But bed rest is the most important one. Bed rest can reduce the pressure on the intervertebral disc, relieve the restricted pressure of the nucleus pulposus on the nerve root, and achieve the reduction or disappearance of clinical symptoms. Traction can increase the intervertebral space and tension of the posterior longitudinal ligament, which is conducive to the partial rejection of the herniated nucleus pulposus. Tui-na massage can relieve muscle spasm, release nerve root adhesions, or change the relative relationship between the herniated nucleus pulposus and the nerve root to reduce the pressure on the nerve root. Epidural cavity injection of a small amount of hormones and anesthetic drugs can inhibit the excitability of nerve endings, while improving local blood flow and reducing local acidosis, thus playing an anti-inflammatory role, blocking the vicious cycle of pain and achieving the purpose of pain relief. 2, surgical treatment: about 10%-20% of patients with lumbar disc herniation really need surgical treatment, so what kind of situation needs surgery? The indications for surgery for lumbar disc herniation include: 1, history of more than six months, after strict conservative treatment is ineffective; or conservative treatment is effective, frequent recurrence and heavy pain. 2. The first episode of severe pain, especially in the lower extremities, where the patient has difficulty moving and sleeping due to severe pain, and is forced to lie in a lateral position with the hip and knee flexed, or even in a kneeling position. 3.Signs and symptoms of single nerve palsy or cauda equina compression palsy are present. 4. Middle-aged patients with a long history of the disease affect their work and life. 5. The history is atypical, but the imaging examination confirms that the nerve root or dural sac is significantly compressed. 6.Lumbar disc herniation is accompanied by lumbar spinal stenosis. Conventional open surgery includes posterior approach for nucleus pulposus removal or anterior approach for retroperitoneal disc removal. The choice of fusion is made on a case-by-case basis. Conventional surgical incisions Minimally invasive surgery for lumbar disc herniation is gradually becoming a trend, including: percutaneous perforator discotomy and disc removal under discoscopy. This technology has the advantages of small trauma (only one needle eye), quick recovery (surgery under local anesthesia) and precise efficacy. Diagram and incision of discoscopic surgery