Recently, Minimally Invasive Spine Center of Orthopaedics Department of Shanghai First People’s Hospital successfully performed intervertebral disc removal surgery for a patient after liver transplantation. The patient is a 30-year-old male, who underwent liver transplantation for liver cancer 2 years ago in Shanghai First People’s Hospital, and recovered well after the surgery, with poor nutritional status due to long-term oral immunosuppressant. Due to lumbar spine disease, the patient developed numbness of the left lower limb after walking for more than 1 year, which seriously affected the quality of life. Due to the complexity of lumbar spine surgery, many comorbidities, and post-liver transplantation, the patient sought medical treatment, but avoided surgery due to the high risk of post-liver transplantation, and the effect of conservative treatment was not good. After many consultations, he finally came to the clinic of Prof. Zhengdong Cai at Shanghai First People’s Hospital. The Department of Orthopedics of Shanghai First People’s Hospital attached great importance to this patient, and conducted a full evaluation before the operation, especially the functional status of the transplanted liver and coagulation function. The patient was in a state of immunosuppression, and in the perioperative period, it was necessary to be more vigilant about complications such as infection. It can be said that the patient’s general condition is on the verge of compensation, and if there is a mistake in one part of the process, the whole treatment process will be ruined. In order to reduce the risk of surgery, the orthopaedic spine team invited Professor Zhong Lin, a liver transplant expert, and Professor Li Shitong, an anesthesiologist, to conduct a comprehensive pre-operative assessment and work out a detailed surgical plan. Based on the preoperative assessment, Dr. Ma Xiaojun of the Department of Orthopaedics believed that special emphasis should now be placed on simplifying the medication during anesthesia to avoid aggravating the burden on the liver, as well as paying attention to the smoothness of the hemodynamics to ensure the perfusion of the vital tissues and organs, and also paying attention to the changes in the coagulation function. In order to reduce the infection and tissue perfusion problems that may be caused by surgery and anesthesia, the Department of Orthopaedics of Shanghai First People’s Hospital performed intervertebral disc removal under local anesthesia, which was a smooth operation with little bleeding, and the patient was successfully completed under local anesthesia in only one hour. The patient is now in good condition and is actively recovering. Intervertebral foraminoscopy has the following characteristics: (1) Less traumatic surgery, smaller scars: compared with conventional open surgery, minimally invasive spinal surgery has smaller incisions and significantly less damage to the paraspinal muscles. Conventional open surgery requires extensive stripping and retraction of the muscles of the lumbar back, which is very traumatic to the patient, while minimally invasive spine surgery is significantly less traumatic than conventional open surgery. Intervertebral foramenoscopic surgery, on the other hand, the incision is generally 25px, and plastic cosmetic suture methods can also be used, with small postoperative scars, which is very conducive to aesthetics. (2) Satisfactory efficacy: Studies have shown that many conventional open surgery patients do not have significant postoperative relief of low back pain, which is mainly due to the excessive damage to the soft tissues of paravertebral muscles caused by open surgery. Minimally invasive spine surgery, on the other hand, has little damage to the soft tissues such as paravertebral muscles, so patients rarely experience postoperative low back pain and have a satisfactory outcome. (3) Short hospitalization time, which can reduce medical costs: After minimally invasive spine surgery, patients are hospitalized for a short period of time in the hospital, and they can return to work earlier, which saves limited medical resources. (4) Easier remedy in case of disease recurrence and reoccurrence: no matter minimally invasive surgery or open surgery, recurrence and reoccurrence may occur after surgery, while minimally invasive surgery is simple to operate again due to less damage to the spine and tissues, and the efficacy is also good. On the other hand, if extensive exposure, laminectomy, spinal fusion and other surgeries are performed, reoperation will be very difficult and the outcome will be poor. (5) High surgical safety, because the intervertebral foraminoscope adopts local anesthesia to enter the intervertebral disc through a small incision, avoiding the side effects of anesthesia drugs, and communicating directly with the patient during the operation, so that any discomforts can be detected during the operation, thus improving the surgical safety coefficient and increasing the surgical efficacy.