Brief description of the case: Male, 26 years old. Low back pain with right lower limb radiating pain for 3 months, conservative treatment was not effective. The pain was obvious and affected sleep. Physical examination: left deviation of trunk, limited bending; positive pressure pain next to L4-5 spine, right lower limb straight leg raising test (+). Imaging data: MRI of lumbar spine suggested L4-5 disc herniation. Diagnosis: lumbar disc herniation (L4-5). Treatment: lumbar discectomy (L4-5) under percutaneous laminectomy. Figure 1, preoperative right lower limb straight leg raising test 30° (+). Figure 2, MRI of lumbar spine suggesting L4-5 disc herniation, with red arrows suggesting significant nerve root compression. Figure 3, intraoperative picture, the intervertebral foramen was found with an 18G puncture needle before the muscle was dilated along the guidewire step by step to place the working channel into the proper position. (The principle of spinal endoscopy is similar to that of gastroscopy and colonoscopy, except that the latter has a natural channel, while the former requires the spine surgeon to artificially make a suitable channel, which is a key step for successful surgery and should be precise.) Figure 4, intraoperative picture, you can see that the nerve roots have been completely decompressed from as if the nerve roots were hidden to fully exposed (the red arrows are the protruding pulpal tissue). If you look closely, you can find inflammatory congestion of the nerve root, which confirms that lumbar disc herniation is not only mechanical compression but also inflammatory irritation factors. (Intervertebral foraminoscopic surgery is a perfect fusion of interventional and arthroscopic techniques that allows complete decompression of the nerve roots under direct vision, with the amount of disc removal aimed at being appropriate and minimizing trauma). Figure 5. Immediately after the operation, the patient had a negative straight leg raising test of the right lower limb, which could reach 70 degrees, and the pain of the right lower limb was completely relieved.