Many patients with numbness in the lower extremities are found to have disc compression of the spinal cord after MRI, and most orthopedic surgeons recommend surgery when they encounter an orthopedic consultation, but is surgery really necessary? What are the indications for surgery? My personal opinion is that surgery requires a combination of imaging and symptoms. If your symptoms are severe, you may need surgery to relieve the compression even if the compression is mild on MRI. If you don’t have symptoms, you may not necessarily need surgery even if you have a severe herniated disc causing spinal stenosis. In fact, lower extremity paralysis due to lumbar herniation is very rare, unless it is caused by trauma. Clinical experience tells us that in many patients, even if the spinal cord is compressed, conservative treatment can relieve the patient’s symptoms and eliminate the inflammation caused by compression, so why operate when conservative treatment is effective? In short, I think surgery should be considered only when a patient with a herniated lumbar disc has no effect after 1-2 months of strict conservative treatment (except in severe cases such as cauda equina syndrome, of course).