Lumbar disc herniation is a common disease in elderly society, causing chronic back and leg pain, which seriously affects the quality of life of the elderly. The most common symptom is sciatica, with pain radiating down the path of lumbar-hip-back-of-thigh-outer-calf-foot, sometimes accompanied by the feeling of a tendon dangling from the back of the thigh. If conservative treatment such as medicine, physiotherapy and traction are ineffective for three months, minimally invasive surgery is required to remove the herniated disc and release the compression on the nerve roots. Most patients with lumbar disc herniation can be cured or significantly improved by minimally invasive surgery, and only a very small number of patients require internal fixation with steel nails. Minimally invasive surgery of the lumbar spine includes the following three types: microdiscectomy, discoscopy and foraminoscopy, and radiofrequency ablation. The pros and cons of these types of minimally invasive surgery are described below. Microdiscectomy: A small incision, only about 2 cm, is made in the back of the lumbar back and a metal surgical channel is inserted. Under the guidance of the C-arm machine, the channel goes straight to the diseased disc through the shortest (about 4-5 cm) and safest (no large blood vessels or nerves along the way) path, and then the diseased disc and nerve roots can be clearly identified under the microscope, and the disc is removed under direct vision, while protecting the nerve roots. The nerve roots are protected at the same time, so there is very little chance of accidental injury to the nerve roots during surgery. Another advantage of this procedure is that although the skin incision is small, the access can be adjusted to a variety of angles, so that the deep exposure is large enough to reveal every corner of the diseased segment with almost no dead space, which is the key to radical surgery: avoidance of leakage. The procedure requires general anesthesia, and only in the state of general anesthesia, where the patient is completely pain-free and does not move around during the procedure, can we ensure that the nerve roots are not accidentally injured, so that complications such as lower limb numbness, motor disorders, and urinary and fecal disorders do not occur after surgery. Discoscopy and foraminoscopy: A 1 cm size incision is made in the lateral lumbar region and a 1 cm puncture cannula is punctured obliquely from the lateral lumbar region to the intervertebral disc under the guidance of an intraoperative C-arm machine. The puncture path is 15 cm long and there is a risk of accidental injury to large blood vessels or spinal nerve roots along the way if inexperienced. After a successful puncture, the disc is removed endoscopically. Since the field of view of the endoscope is very limited, only as much as possible can be seen, and the whole lesion cannot be seen, so it is difficult to make a complete cut. The nerve root is often not visible during the procedure, which is not conducive to nerve root protection. The surgery is usually done under local anesthesia because the nerve roots cannot be seen during surgery, and the surgeon often needs to rely on the patient’s sensation (whether there is numbness or soreness) to determine whether the nerve roots have been contacted, so there is a deficiency in nerve root protection, and postoperative numbness and weakness of the lower limbs are more common. In addition, local anesthesia patients are more painful during the operation. Radiofrequency ablation: Under the guidance of C-arm machine or CT, a 1 mm needle is punctured into the interior of the intervertebral disc, and then the tip of the needle is heated by radiofrequency current, and the temperature reaches about 55 degrees, and the nucleus pulposus of the intervertebral disc will be slightly reduced in size after heating, thus reducing the pressure on the nerve root. The safety of radiofrequency ablation is very good, and it is suitable for elderly people over 75 years old, or patients with heart, lung, liver and kidney diseases. Since the nerve root is still in a state of compression after radiofrequency, only to a slightly reduced extent, the effect is limited, not to mention incurable, and usually relapses after 3-6 months. In summary, we can know that only microdiscectomy can achieve radical cure and is therefore the preferred minimally invasive procedure. The procedure combines access technology and microsurgery, and the diseased disc can be completely removed through an incision of about 2 cm, and the nerve root compression can be satisfactorily released. The surgery is minimally invasive, and the patient can walk on the ground after 3 days, with a short hospital stay and low cost.