Lumbar disc herniation is the most common cause of low back and leg pain, and the number of patients suffering from it continues to grow. For patients who need surgery, traditional open surgery was the only option in the past, but it was more damaging. With the development of minimally invasive concepts and technologies, minimally innovative techniques are emerging. Currently, the most popular and effective minimally invasive technique for the lumbar spine is the lumbar foraminoscopy technique. Many patients who come to me by name often ask me a lot about foraminoscopic surgery. Most of them have the initial intention of not wanting to do major surgery and have heard that minimally invasive surgery is possible, but they are largely ignorant of this new procedure and do not know if they can do it. I will popularize the most common questions about foraminoscopic surgery below. Question 1: Can I have foraminoscopic surgery in my case? For most patients with lumbar disc herniation, conservative treatment is usually the first option, and surgery is recommended for patients who have received regular conservative treatment for 3-6 months or whose symptoms do not improve significantly. Surgery is recommended once the patient has lumbar pain with radiating pain in the lower extremities, numbness in the nerve distribution area of the corresponding segment of the lower extremities, and decreased muscle strength; and a herniated disc on imaging consistent with the corresponding clinical symptoms and signs. With the continuous improvement of intervertebral foraminoscopy technology, the time of conservative treatment can be appropriately shortened and minimally invasive treatment can be performed earlier for patients with more serious conditions. Minimally invasive surgery is not recommended in the following cases: (1) multi-segmental lumbar disc herniation; (2) lumbar disc herniation with extensive spinal stenosis; and (3) lumbar instability. Question 2: How long do I need to stay in the hospital for laminectomy? The total hospital stay is usually about one week, and you will be discharged from the hospital about 3 days after surgery. The preoperative period is mainly for relevant preoperative examinations to fully assess the patient’s specific condition and risk factors. The length of stay can be further reduced if the results of the relevant preoperative imaging studies are available at the time of admission. Some hospitals in China, including our hospital, are now gradually carrying out day surgery, which can further shorten the length of hospitalization for minimally invasive lumbar spine surgery. Question 3: I am afraid of pain, will it be painful during surgery? The foraminoscopic technique pursues the principle of minimally invasive surgery to reduce the risk and injury of surgery. Therefore, the surgery is usually performed under local anesthesia, and the patient is conscious throughout and can communicate with the operator. Therefore, many patients worry that the operation will be painful. In fact, with adequate local anesthetic, the procedure will not be very painful. When the surgical instrument touches the relevant lesion, the patient will have a slight sensation and the operator will adjust the surgical process according to the patient’s reaction. For patients who are nervous, appropriate analgesic and sedative drugs will also be given during the surgery. The best advantage of local anesthesia is that the recovery is extremely fast and there is basically no anesthetic damage. Question 4: Is the surgery risky? There are risks associated with any surgery, and the same is true for laminectomy, except that laminectomy is less risky. Real-time intraoperative x-ray fluoroscopy is used during puncture and access creation to ensure safe progress, and the entire field is exposed to the monitor during surgery, giving the operator a clear picture of the entire operation. Question 5: How long will it take to get out of bed after surgery? How long does it take to recuperate? While traditional open lumbar spine surgery generally takes about a week to get out of bed after surgery, laminectomy patients can generally get out of bed in 1-2 days after surgery and can go to the bathroom or get up to eat on their own. However, they still need lumbar protection, which generally lasts for 1-3 months after surgery. Minor postoperative self-care activities can be performed, but 4-6 weeks of rest is recommended because this is the “golden period” for recovery and recurrence reduction. After 4-6 weeks, the amount of activity can be gradually increased, and rehabilitation exercises for the muscles of the low back can be gradually increased. Question 6: The postoperative effect is good and the pain is basically relieved, but why do I still have numbness all the time? Most patients can get relief from back and leg pain after laminectomy, but some patients may not get relief from numbness soon. This is usually seen in patients with a long history of disease where the nerves have been compressed by the disc for a long time. After decompression, the recovery of sensory nerve fibers is a long process. Therefore, patients are recommended to take nerve-nourishing drugs and appropriate limb function exercises after surgery, and most of them can gradually recover within 3 to 6 months. Question 7: How do I perform rehabilitation exercises after surgery? With lumbar spine surgery, adhesions in the spinal canal and nerve root canal are inevitable, and severe nerve adhesions can cause severe symptoms. One of the outstanding advantages of minimally invasive lumbar spine surgery is that adhesions are very mild. However, straight leg raising exercises early after minimally invasive surgery can effectively drive nerve gliding, which is a good way to prevent and improve nerve root adhesions, as well as to exercise lower extremity muscle strength and improve blood circulation. Exercises can be performed in bed on the first day after surgery, alternating 10 straight leg raises bilaterally each time for 3-5 cycles daily depending on physical strength, which can last until 2 weeks after surgery. The middle and late back exercises can be found in my previous postings. Question 8: How long after surgery can I remove the stitches? How soon can I shower? The laminectomy incision is only about 0.7 cm and is usually closed with absorbable surgical thread, so there is no need to remove the stitches. The dressing can be removed in about 10 days after the surgery. After the lumbar incision has basically grown, you can take a bath about 1 month after surgery, and try to keep the incision out of water beforehand. Question 9: Is there any recurrence after surgery? There is about a recurrence rate of about 4% after minimally invasive lumbar spine surgery. Open lumbar spine surgery usually removes the diseased disc completely and decompresses it completely. Minimally invasive lumbar spine surgery mainly removes the herniated disc, and the remaining disc continues to degenerate after the disc is removed. For example, after the disc has degenerated, the remaining disc continues to move and form a new herniation. Some patients refuse minimally invasive treatment for fear of recurrence, but in fact, as technology continues to develop, the recurrence rate will gradually decrease. After recurrence, patients are feasible for complete open decompression therapy. Usually, patients can prevent recurrence by reducing the triggering factors that lead to reherniation. It is to minimize bending movements and reduce the force on the lumbar region, especially to minimize bending and lifting or lifting heavy objects, and to reduce twisting and other movements.