Decompression and immobilization fusion is the gold standard for spinal surgical treatment, so is it the gold standard for surgical treatment of lumbar disc herniation? Because nerve compression is the reason for surgical treatment of herniated disc, decompression becomes necessary for surgical treatment, fusion is the gold standard for surgical treatment of spinal instability, and most of the herniated discs do not have the manifestation of instability, which has been confirmed by a large number of inquiries into the medical science, so fixation and fusion is not a necessary measure for surgical treatment of herniated discs. Especially for young patients, because of long working hours, large lumbar load, limited activities after fixed fusion, neighboring segment degeneration disc herniation is unavoidable, and there is a great possibility of surgery after 5 years. Therefore, young patients should not be fixed fusion. In order to avoid the risk of major surgery, elderly patients should simplify the surgery, as far as possible, choose the minimally invasive technology of intervertebral foraminoscopy, which is safe, reliable, effective, and can be discharged from bed after surgery. However, at present, for lumbar intervertebral disc herniation and lumbar spinal stenosis surgical treatment is commonly used in the way of decompression and immobilization to ensure the success of fusion, although the leg pain is relieved, the spinal activity is restricted, which is manifested as the stiffness of lumbar region, soreness and sleepiness or even a serious squeezing sensation, which is very painful, and difficult to be relieved, and it is related to the factors of the extensive stripping of lumbar dorsiflexors and the immobilization of spine, which has brought many problems at present, and it is worth numerous scholars to study and explore. The introduction of intervertebral foraminoscopy technology opens up a safe, effective and minimally invasive treatment pathway for the treatment of this disease, which is more in line with the requirements of the human body’s physiological activities and physiological functions, with small trauma, fast recovery, low cost, light burden, and the ability to get out of bed on the next day and return to work at an early stage, and the surgery does not require extensive stripping of lumbar dorsiflexors, resection of vertebral structures and spinal immobilization, and has no complications related to the open surgery, which has been favored by patients and deserves to be promoted and applied. It has been favored by patients and is worth promoting its application. Various spinal fusion surgeries have been used for nearly a century, and “spinal fusion” has become the widely accepted “gold standard” for the treatment of spinal surgery. In many spinal surgeries, the success of fusion is one of the most important criteria for determining the success of the surgery. Internal fixation can stabilize the spine, eliminate clinical instability symptoms, maintain the spinal sequence, and significantly improve the success rate of spinal fusion, with reliable clinical efficacy, so it is a widely used clinical procedure. With the improvement of people’s requirements and the immediate stabilizing effect of internal fixation can make patients get out of bed early, fixed fusion surgery is also widely used in the treatment of lumbar disc herniation. However, after spinal fixation and fusion, the loss of spinal motion segments and the accelerated degeneration of adjacent segments will definitely form new disc herniation and spinal stenosis, which seriously disturb the patients, and it is a problem worth exploring. I. Do lumbar disc herniation and lumbar spinal stenosis require immobilization and fusion? Lumbar disc herniation and lumbar spinal stenosis require immobilization and fusion only in some cases where there is instability of the lumbar spine, or where the stability of the lumbar spine is damaged after decompression. In the past, for the treatment of lumbar disc herniation and lumbar spinal stenosis, it was a very good clinical basis to use simple decompression to achieve satisfactory results, and there was no obvious discomfort in lumbar activities after the operation, but the bed-ridden time was long, and individual patients needed to be treated again due to lumbar spine instability and corresponding symptoms. Therefore, in the late 90’s in China, fixation and fusion were gradually carried out at the same time of decompression to reduce the bedtime and increase the fusion rate in order to improve the therapeutic effect. However, posterior decompression and fixation and fusion have been associated with painful manifestations such as lumbar soreness and discomfort due to laminectomy, extensive stripping of the posterior muscles of the laminae, muscle fibrosis, and loss of innervation. Even if the fusion is successful, there are many problems to consider in the later stages: 1. Degeneration of adjacent segments and new disc herniation. 2. Secondary instability. Loss of physiologic activity. Secondly, fusion surgery is not a simple surgery, which increases the probability of complications 1. Errors and/or failures of internal fixation of pedicle nails 2. Loosening of intervertebral fusion devices 3. Acute or chronic infections 4. Nerve root and/or ganglion injuries In order to avoid the pain caused by many of the above mentioned undesirable problems, many scholars have explored and researched for nearly one hundred years, and the application of minimally invasive methods for the treatment of spine-related diseases has achieved a breakthrough progress. The invention of intervertebral foraminoscopic targeted minimally invasive technology has brought the treatment of lumbar disc herniation and spinal stenosis into a truly minimally invasive era, which can treat most patients. The surgery is simple, can remove the herniated disc and enlarge the intervertebral foramen to decompress without affecting the spinal stability, can achieve the purpose of decompression without destroying the stability of the spinal column, and can get out of bed after the surgery, the technology has been very mature and favored by many doctors and patients. Therefore, if a herniated disc is diagnosed, before deciding to operate, first consider the method of intervertebral foramenoscopy targeted minimally invasive technology, rather than major surgery and internal fixation and fusion. Only a small percentage of patients with symptoms of cauda equina compression, severe bony stenosis of the spinal canal, spinal instability and severe muscle weakness are considered for fixed fusion surgery. Adhere to the principles of being able to go small and step therapy. Multi-gap, long-segment fixed fusion should never be used, which not only increases the difficulty and operation time, but also limits the mobility of the spine and seriously affects daily life. Therefore, for simple lumbar disc herniation, don’t pursue major surgery and internal fixation to get rid of it once and for all, because degeneration is inevitable. Therefore, surgery is simple to be able to relieve clinical symptoms can be, which is the wisdom of disease treatment. Furthermore, it is the lumbar disc herniation and lumbar spinal stenosis that need to be treated clinically, not the imaging diagnosis of lumbar disc herniation and lumbar spinal stenosis. Of course minimally invasive treatment is not foolproof, but most disc herniations can be treated minimally invasively with transforaminal techniques. With advances in medicine, improvements in medical devices, and improvements in medical technology and surgical techniques, minimally invasive techniques will surely solve most disease problems, not just herniated discs.