Lumbar disc herniation is one of the most common disorders today. The age of the disease is mostly between 20 and 50 years old, accounting for about 80%. The age of onset tends to be younger. The incidence of lumbar 4-5 and lumbar 5-sacral 1 is the highest, accounting for about 90-96%. The two cases of lumbar disc herniation recently completed at the Spinal and Spine Center of Sanbo Brain Hospital of Capital Medical University are relatively representative of the cases of lumbar disc herniation that can be considered as one for ten. Features of the 1st case: preserving the integrity of the bony structure, cutting through the yellow ligament, removing only the nucleus pulposus for decompression, preserving the structural integrity of the fibrous ring, and effectively relieving the nerve compression without disturbing or changing any structure. Characteristics of the 2nd case: recurrent lumbar disc herniation with severe nerve root compression, local adhesions, and unclear anatomical structures, any rash decision and action by the surgeon during surgery would cause lifelong regret for the patient. Microscopic techniques and intraoperative neurophysiological monitoring are necessary for safe and effective surgery. Recurrent lumbar disc surgery should be a realistic level 4 surgery. Case 1: Case presentation: The patient was a middle-aged male, admitted to the hospital mainly because of low back pain with right lower extremity pain for 6 years, aggravated for more than 6 months. The patient had lumbar pain with right lower extremity radiating pain after sitting for 6 years, the pain could not be relieved by itself, no limb weakness, numbness, no unstable walking, the patient was treated at local hospital with lumbar MRI suggesting lumbar disc herniation, conservative treatment was recommended, and the lumbar pain with right lower extremity pain improved after symptomatic treatment such as dehydration was given. The patient was admitted to our department as “lumbar disc herniation”. Physical examination: normal movement of the limbs, normal muscle strength and muscle tone. The right posterior calf and plantar superficial sensation was decreased, the right knee-ankle reflex was active, the left knee-ankle reflex was normal, the double Babinski sign was negative; the right straight leg raising test was positive at 60°, and the strengthening test was positive. Finger test, alternating test, heel-knee-shin test were negative, heel-toe test was negative, and Romberg’s sign was negative. Ancillary tests: MRI of lumbar spine (2021-1-10, external hospital): L5-S1 lumbar disc protrusion. Preliminary diagnosis Lumbar disc herniation (L5-S1) Surgical plan: The patient was admitted to the hospital mainly in bed, with relief of lumbar pain and right lower extremity pain. Because of the patient’s previous history of hypertension and cerebral infarction, a simpler surgical option was chosen to relieve the patient’s symptoms, and lumbar disc herniation nucleus pulposus removal was selected for surgery. After removing the nucleus pulposus, the fibrous annulus was seen to be intact, with no clear breakage and adequate nerve decompression, so no additional fibrous annulotomy was performed. Postoperative situation: After the operation, the patient’s muscle strength of all four limbs was level V. The pain disappeared and the patient moved to the ground on the second day after the operation. The postoperative MRI of the lumbar spine showed that the lumbar disc compression was released. Case 2: Case presentation: The patient was a middle-aged male, admitted to the hospital mainly for more than 5 years after lumbar disc herniation and left hip with left lower limb pain for more than 1 year. The patient was found to have a herniated disc at L4-5 more than 5 years ago due to lumbar and leg pain, and underwent lumbar disc removal at a local hospital, which relieved the patient’s lumbar and leg pain after surgery. Subsequently, the patient’s pain gradually increased, and an MRI of the lumbar spine was performed at the local hospital, suggesting that the L4-5 intervertebral disc protruded to the left posterior side. The patient was admitted to our department as an outpatient with “lumbar disc herniation”. Physical examination: normal movement of both upper limbs and right lower limb, normal muscle strength and muscle tone, grade IV muscle strength and normal muscle tone of left lower limb. There was no significant abnormality in whole body sensation. Both knee and ankle reflexes were normal, Babinski’s sign was negative; straight leg raising of left lower limb was positive at 60° and reinforcement test was positive, straight leg raising of right lower limb was positive at 45° and reinforcement test was positive. Ancillary tests: MRI of the lumbar spine (2020-11-26, outside hospital): L4-5 disc protruded to the left posteriorly. Postoperative status: Postoperatively, the patient had V-level muscle strength in all four limbs and his symptoms disappeared. Postoperative reexamination of the lumbar spine MRI showed that the lumbar disc compression was released