Lumbar disc herniation is not the most serious disease in spine surgery. However, it is of great concern to the majority of patients with lumbar herniation due to its high incidence and impact on one’s quality of life and work. There are many clinical treatments for lumbar disc herniation, and different doctors may give very different treatments and recommendations, while many patients lack the relevant knowledge and are uncertain and even have many anxious behaviors regarding surgical and non-surgical, minimally invasive and open surgery. The simple answer to the question of whether surgical treatment is needed after a lumbar disc herniation is that non-invasive and minimally invasive treatment is the first choice for any disease, and open surgical treatment is the last to be considered. Therefore, if the symptoms of lumbar disc herniation are severe and conservative and other treatments are ineffective, minimally invasive surgery can be considered. Otherwise, continue conservative treatment. There are few patients who need open fusion for lumbar disc herniation alone. There are roughly 3 conditions as to whether or not surgery is required for lumbar disc herniation. The first case is a necessary surgery: the disease is not a malignant disease and will not involve the patient’s life safety, but it will produce severe pain symptoms, and in some cases even seriously affect the patient’s quality of life, work status and psychological state. This is mainly the case for patients who have damaged the cauda equina nerve or have developed weakness symptoms. The second condition is debatable surgery: the disease is often effectively treated conservatively, therefore, its preferred treatment is conservative treatment, but not all patients conservative treatment is effective, so after conservative treatment is ineffective, or conservative treatment is effective but the clinical symptoms recurring patients need to consider surgical treatment. The third situation is that surgery is not needed: the clinical manifestations of the disease are light and heavy, if the symptoms can be tolerated and can maintain normal work and life, do not receive surgical treatment, to know that surgery is risky, conservative treatment, interventional treatment and other methods for lumbar disc herniation are effective and can be chosen at your discretion. If a patient asks me whether to operate for lumbar disc herniation, my answer is, first of all, I am not a fortune-teller, I must fully understand your general condition, such as: medical history, symptoms, signs, imaging data, and the best imaging data is the three evidence complete (X-ray, CT, MRI), then the doctor can provide treatment recommendations based on professional knowledge. In the first case, surgery is recommended to avoid unrecoverable clinical symptoms. In the second case, try to choose a less invasive treatment method. In the third case, resolutely refrain from surgery. We should understand that the choice of surgery is influenced by many factors, mainly three aspects: 1, patient side: such as the patient’s age, gender, race, height, weight, occupation, education, family situation, medical history, severity of signs, stage of the disease, other comorbidities, feedback from surrounding patients’ treatment results, etc., are all factors that affect their choice of whether to operate or not. For the same patient, the treatment plan may differ between older doctors and younger doctors, doctors in different levels of hospitals, and doctors from different countries due to the different degrees of knowledge of doctors. 3. Social aspects, mainly influenced by social factors such as the patient’s medical insurance reimbursement ratio.