Among the treated patients with lumbar disc herniation, most of the patients with more severe disease require open lumbar spine surgery, except for the less symptomatic ones who can get good relief by conservative treatment and minimally invasive foraminoplasty. Two types of spinal fusion procedures predominate: posterior interbody fusion (PLIF) and transforaminal approach lumbar interbody fusion (TLIF). Spinal fusion is a procedure in which two or more vertebrae are fused together. Usually, after removing the herniated disc and reducing the pressure between the vertebral bodies, autogenous bone or artificial bone is implanted in the original location of the disc, and the adjacent vertebrae are fused together by internal fixation to achieve treatment. PLIF, which refers to posterior interbody fusion, is an operation to stabilize the spine and improve fusion by removing the dural sac and nerve roots, removing the intervertebral disc, implanting a bone graft or fusion device in the intervertebral space, and supplementing it with a posterior nail rod internal fixation device. I. Scope of decompression The lower 1/3 portion of the upper adjacent vertebral body plate bites out the medial 1/2 of the articular synovial joint resection including partial resection of the overlapping lower articular synovial and vertebral plate edges. II. Treatment of the intervertebral disc III. Implantation of the fusion device: the intervertebral fusion device is implanted into the intervertebral space IV. Internal fixation: posterior fixation and fusion using pedicle screws and titanium rods Advantages of PLIF 1. 2. The disc tissue can be removed more completely, and the bone block or fusion device placed into it supports the increased height of the posterior intervertebral space and releases the nerve root compression 3. The physiological curve is restored by intervertebral support and posterior internal fixation Disadvantages of PLIF 1. Too much stretching leads to nerve and dural sac damage and epidural scar formation. 2. Narrow epidural space in lumbar 3 and above segments is not suitable for operation. TLIF, which refers to lumbar interbody fusion through the intervertebral foramen. It is performed through the intervertebral foramen to complete decompression and perform bone grafting or implantation of an intervertebral fusion without removing the lamina. I. Extent of decompression II. Exposure of the intervertebral disc One side of the inferior and part of the superior articular process is removed to expose the intervertebral disc. Advantages of internal fixation of the implant TLIF 1.Entering the intervertebral space through the intervertebral foramen protects the anterior longitudinal ligament and most of the posterior longitudinal ligament from destruction, prevents the implant from shifting, and facilitates the fusion of the implant. 2.To avoid excessive pulling on the dura and nerve roots, and to reduce nerve root and dural injury. 3.The amount of intraoperative bleeding and postoperative drainage is less. Disadvantages of TLIF 1.The damage to the paravertebral tissues is large, and the damage to the paravertebral muscles leads to the postoperative weakening of the strength and chronic low back pain. 2.The surgical approach is complicated. 3, the operation time is longer. In short, both PLIF and TLIF have their own advantages, but which is the better surgical procedure? This depends on the specific situation and needs to take into account the patient’s physical condition, medical condition and other related issues. If you need surgery to solve your back pain problem, we will develop a customized treatment plan for you.