Low back pain is the second most common condition in the United States, with 84% of adults having had low back pain at some time. Most low back pain is self-limiting and requires no specific treatment. The annual cost of treating low back pain in the United States is $100 billion, and 75% of that cost is spent on patients who have it. Imaging within the first 4-6 weeks is not necessary unless combined with progressive neurological abnormalities or highly suspected systemic disease (e.g., spinal tumor, infection) lumbar disc herniation requires surgical treatment if surgical treatment is ineffective. Depending on the condition, different stepwise surgical methods can be used. 1.Minimally invasive treatment: For patients with small disc herniation, mild disc lesions and good intervertebral stability, minimally invasive treatment can be used, including radiofrequency ablation, ozone, laser, etc. 2, non-fusion surgical treatment: including the traditional small open surgery, full plate surgery, as well as the discoscopy and spinal stabilization surgery carried out in recent years. 3, fusion surgery treatment: for disc herniation or prolapse, disc lesion degree is heavy, intervertebral instability, significant narrowing of the intervertebral space, revision surgery, etc., sexual fusion surgery treatment is required. If there is no significant improvement in symptoms after 4-6 weeks, a lumbar positive and lateral x-ray plain film is usually sufficient. CT and MRI are more sensitive than radiographs for spinal infections, tumors, disc disease, and spinal stenosis, but >50% of bulging discs can be asymptomatic and asymptomatic disc herniation is not uncommon, making disc prolapse a more valuable diagnosis. High suspicion of spinal tumor or infection, and persistent low back pain after 12 weeks. The above information is quoted from the latest up-to-date clinical guidelines. Low back pain is very common, but in most cases it can be relieved with appropriate rest or with some medication or massage. Only a small number of patients require further treatment, so an important role of the clinician is to use the limited resources on the right patient. Imaging is important for diagnosing spinal disorders, but there is still a balance to be struck between necessity, cost, and radiological damage. In general, patients with low back pain can resolve most of their problems with a physician’s consultation and examination, supplemented by X-rays, and even then, lumbar spine X-rays should not be applied casually. Of course, the situation in China is slightly different, and we lack a good general practitioner system, so if the doctor cannot ensure easy follow-up of the patient, he or she may apply X-ray examinations more often to reduce the cases of missed diagnosis and misdiagnosis. Although CT and MRI of the lumbar spine are theoretically more advanced and “better” in the eyes of the patient, in reality, X-rays provide good basic information and are more advantageous in reflecting the sequence of the spine, etc. As a patient, it is important to get rid of the misconception that “expensive is good” and listen to the doctor’s advice. As a patient, it is important to get rid of the misconception that “expensive is good” and listen to the doctor’s advice to choose a reasonable test. From the perspective of radiation exposure, lumbar CT > lumbar X-ray plain film, while lumbar MRI has no radiation exposure, so from the perspective of reducing radiation damage, lumbar X-ray plain film + MRI is a good combination. In addition to the most basic lumbar spine X-ray, there are also lumbar anterior flexion and extension radiographs (also called lumbar power radiographs) for understanding the presence of lumbar instability and lumbar oblique radiographs for understanding the presence of isthmic fractures (mostly used for patients with lumbar spine slippage). Lumbar CT is superior to MRI in showing bony lesions, and it is also necessary to refer to lumbar CT when planning surgery (e.g., CT is superior to MRI in showing disc calcification), and it is recommended that lumbar CT be used selectively. Finally, it is important to remind patients that a herniated disc on imaging does not mean a herniated disc, and as mentioned in the guidelines, more than 50% of lumbar disc bulges As mentioned in the guidelines, more than 50% of lumbar disc bulges can have no clinical symptoms and there are few asymptomatic lumbar disc herniations. Therefore, don’t just put on a “lumbar disc herniation” hat when you find a lumbar disc herniation on CT or MRI, you must combine symptoms and physical examination to make the above diagnosis.