The choice of indications for the treatment of herniated discs is of first importance, and the concept of step therapy is of second importance. Treatment methods for herniated discs can be broadly divided into: 1) conservative therapy; 2) surgical resection; and 3) percutaneous puncture techniques in between. In fact, each case of disc herniation presents different characteristics from the patient’s age, occupation, degree of degeneration, disease duration, and severity of the disease, so no one method can cure all disc herniation. Exactly which method to take is the first important choice of indications, depending on the patient’s condition and the doctor’s skill. The concept of step therapy for herniated discs is second most important. A herniated disc is one of the degenerative diseases of human beings, a disease that is related to life first. In other words, one should not live without being free from it and should be prepared to fight it for a long time. Nowadays, although there are various methods of treating herniated discs, most of them are conservative and minimally invasive methods of treatment for the herniation based on the condition. The entire treatment process takes a period of time, coupled with a certain amount of recovery time. For the patient, it is unrealistic to expect a short-term or one-time cure. For the physician, expecting a short-term or one-time cure of the patient’s disease can easily lead to overtreatment. Each treatment has its own optimal indications, and the doctor should choose the treatment that will give the best results, rather than attempting to replace all treatments with the one he or she is familiar with. Therefore, for the 10-20% of patients and doctors who are not very satisfied with the results of treatment, both sides should be prepared for a protracted battle and repeated treatment. Especially for patients with less severe disease, the ultimate treatment method, fusion, is not advocated until a certain point. Disc herniation: It is a partially self-healing or self-limiting disease that can be relieved in most cases by rest, traction, and a variety of different conservative therapies. For patients with herniated or even free discs, conservative treatment is a symptomatic but not a curative approach. For this group of patients, surgical treatment, which treats the symptoms but not the root cause, is the necessary option. Surgical treatment has the characteristics of exact efficacy, short course of treatment and low recurrence rate, but there are two sides to everything. Surgical treatment has its own risks. The process of surgical treatment itself is the process of causing secondary damage to the organism, compared with the primary disease of the organism, this pain is less, this surgical process is is acceptable. The risks of surgery include: infection, trauma of surgery, possible side injuries caused by surgery (nerve roots, intravertebral vessels, large prevertebral vessels, abdominal organs), late stage diseases including: more damage to bone structure caused by medical origin, nerve root adhesions, progression of the disease itself leading to narrowing of the spinal space, lumbar instability, small joint hyperplasia, secondary spinal stenosis, etc. The creation of these problems and the development of optical technology, imaging technology, and mechanical engineering technology have promoted the development of minimally invasive techniques. Since surgery has many advantages and disadvantages, minimally invasive techniques were created by building on the strengths and avoiding the weaknesses. An endoscopic technique has emerged in the method of disc surgery, which is currently the least damaging direct vision disc surgery technique. Endoscopic surgery: It is the first step of open surgery for patients for whom various conservative treatments and interventions are ineffective or unsatisfactory relief, and is a prelude surgery to various fusion surgeries. Surgical discectomy: is the traditional and classical treatment of herniated discs, with considerable progress in discectomy surgery as equipment technology has improved. The surgical procedure is characterized by a variety of features, including: percutaneous endoscopic discectomy, percutaneous microdiscectomy, small incision discectomy, and trans-anterior (extraperitoneal, transperitoneal) discectomy, depending on the size of the trauma. On internal exposure there are: intervertebral foramen approach, intertransverse process approach, interlaminar opening, hemi-discectomy, total discectomy, etc. The treatment of the intervertebral disc includes: herniated disc tissue removal, nucleus pulposus excision, discectomy, etc. Different surgical methods have their own characteristics. It depends on the hospital equipment, the operator’s habits, the patient’s condition, and the type of herniated pathology. The latest view is that the smaller the surgery, the less damage the patient will suffer and the faster the patient will recover, provided that the herniation is clearly exposed, the herniation is completely removed, the nerve root is adequately decompressed, the nerve tissue is not damaged, and postoperative adhesions and other complications are reduced. Minimally invasive methods have therefore become the surgical methods sought by patients and actively recommended by doctors.