The pathogenesis of lumbar disc herniation has been briefly described in the previous articles. For most patients with lumbar disc herniation, conservative treatment is possible, but after all, there are still patients for whom conservative treatment is ineffective, effective but recurrent or particularly severe symptoms, and surgery has to be used. Today I will mainly talk about the minimally invasive surgery in surgical treatment. 1. Epidural hormone injection. Strictly speaking, this is not a surgery, but a kind of puncture. However, it is listed here because there is some damage and it needs to be done in the operating room. The mechanism is: to puncture into the spinal canal through the interspinous process and the intervertebral space in the posterior spine, but not into the epidural sac, and inject hormone into the interface between the herniated disc and the compressed nerve root, relying on the powerful anti-inflammatory effect of hormone to reduce or eliminate the injury inflammation and chemical mediator-mediated chemical inflammation caused by the compression of the nerve root, and at the same time, reduce the edema of the nerve root so that the degree of compression can be relieved to a certain extent. relief, which in turn relieves the patient’s low back pain symptoms. However, this treatment does not remove the herniated nucleus pulposus, and theoretically the nerve root compression remains and the symptoms are only temporarily relieved. Some patients with milder, and relatively stable symptoms have good results. There are also a significant number of patients who do not have significant results or are prone to recurrence. In actual clinical work, this method is used more in some small hospitals because the starting point is low and it is relatively easy to master. The reason why large hospitals do not use this method is that the patients in large hospitals are more serious and not suitable for using this method. 2.Plasma radiofrequency myeloablation. It can be performed under local anesthesia, mainly for patients whose outermost layer of the intervertebral disc is still intact, the radiofrequency head with a diameter of about 3mm is inserted into the intervertebral disc, and the plasma radiofrequency is used to dissolve a part of the nucleus pulposus after vaporization, which reduces the pressure within the disc, thus causing the herniated nucleus pulposus to retract to a certain extent and relieving the compression to solve the symptoms. However, a significant number of patients have unsatisfactory symptom relief or are prone to recurrence, mainly because plasma radiofrequency acts within the intervertebral space to retract the nucleus pulposus by reducing the internal pressure, rather than directly removing the herniated disc. Also, the nucleus pulposus that has been dissolved by radiofrequency will continue to degenerate, even more rapidly. So this is also a part of the stepwise treatment of the disc, but not the final treatment. 3.Endoscopic discectomy. At present, it is mainly posterior discoscopy and foraminoscopic nucleus pulposus resection. The mechanism is: a minimally invasive operation channel is established by percutaneous puncture under local anesthesia, and the herniated nucleus pulposus is removed by minimally invasive instruments with the help of fiberoptic endoscope, which also deals with the residual nucleus pulposus tissue between vertebral bodies and reduces the chance of re-protrusion after the nucleus pulposus continues to degenerate. The advantages are: direct removal of the exiting nucleus pulposus tissue to remove nerve root compression; less interference with the lumbar muscles, ligaments and bony structures of the spine, and faster postoperative recovery. The disadvantages are: the treatment effect cannot be achieved for patients with combined lumbar spinal stenosis, lumbar spinal slippage, scoliosis and kyphosis; the treatment requirement cannot be achieved for patients who need interbody fusion; and the space in the spinal canal is narrow and the operation is difficult.