In terms of the condition alone, this patient is in fact very serious and would normally need to be considered for surgery or not, but the patient has the advantage of being “young”, which makes surgery not so necessary. Lumbar spine disease requires symptoms! This patient’s description is relatively simple: herniated lumbar disc and spinal stenosis, which are only imaging findings, but in reality, we need to consider other conditions, the most basic of which is the patient’s clinical symptoms. In clinical practice, we often collectively call it lumbar and leg pain because patients with lumbar spine disease often have lower limb symptoms, and in addition to lumbar pain, they can also have leg pain and leg numbness symptoms, and there is no difference between the two who is lighter and who is heavier. We need to judge the stage of development according to the area of symptoms, for example, the patient’s pain radiates from the center of the waist to both sides, and gradually radiates from the waist to the lower extremities, etc. These all indicate the aggravation of symptoms and The disease is developing. In addition to severe pain and numbness in the lower extremities, some patients may also experience instability of the lower extremities and stepping on cotton, which indicates that the motor function of the nerve has been affected or even damaged, which should be treated surgically. There is also a situation where the cauda equina is affected, and this is reflected in the patient’s symptoms are more embarrassing, that is, urinary and fecal dysfunction, and many patients have difficulty associating it with the lumbar spine, which may delay the treatment, and this time should also be treated with surgery in a timely manner. In fact, this patient’s controversy lies in his age. If he were older, he should have been operated on in time! The coexistence of lumbar disc herniation and spinal stenosis is mostly seen in middle-aged patients, and young people like this one, who are only in their 20s, rarely have both conditions, but mostly have a simple herniation. If there is only a herniated disc and the patient is still young, I would definitely recommend conservative treatment, but this patient also has spinal stenosis, then conservative treatment is actually not very effective, and even for some patients with severe disease, even surgery is not guaranteed to be effective. There are some other reasons, if the patient is male, in addition to the advantages and disadvantages of the treatment itself, but also need to consider the impact of symptoms on daily life, work, because 27 years old is in the rising stage of life, whether it is love or work are the first big thing, this is also better to pay attention to, once the bad consequences, then it will be trouble. This patient’s choice, more need to look at their own, conservative and surgery have reasons, the patient should be based on their own situation for a reasonable analysis, I say my advice: 1, if the patient is simply lumbar pain, then the first choice of conservative treatment (do not massage, do not massage, at least do not accept informal massage), even just to relieve can be, but need to pay attention to the usual maintenance. 2, if the patient is just simple back pain, you can take conservative treatment for three months, if the relief will continue, and vice versa, surgery. 3.If the patient has difficulty walking or urinary and fecal disorders in addition to pain, then surgery is preferred.