The MED technique is essentially the same as open surgery in that it allows for partial resection of the ligamentum flavum, lamina and synovium, enlargement of the nerve root canal, release of perineural adhesions, and removal of the intervertebral disc, and is a minimally invasive and endoscopic version of open surgery. When MED was first used in clinical practice, it attracted the attention of many clinicians and patients, however, in practice it was found that MED has the same learning curve as other surgical approaches. The more serious complications and conversions to open surgery were in the first 10 cases, and the time to surgery leveled off at about 30 cases. Successful completion of a minimally invasive spine surgery requires not only a high level of instrumentation, but also a high level of tactile sensitivity, spatial discrimination, and dexterity. As a minimally invasive surgeon, special training is necessary to master the local anatomy and open surgical procedures, surgical positioning, instrument installation and use, and advance training on cadavers and animals. However, once the technique is mastered, complications, postoperative pain and discomfort can be greatly reduced, allowing patients to return to normal life in a shorter period of time compared to the implementation of traditional open surgery. Zheng Zhaomin et al. summarized the postoperative efficacy of the MED system in 26 papers on the treatment of lumbar disc herniation in China from 2000 to 2002: 1018 cases were evaluated by Nakai criteria, with an excellent rate of 95.99%; the other 959 cases were evaluated by Macnab criteria, with an excellent rate of 95.9%, and the overall excellent rate was more than 95%. Perez et al. found that there was no significant difference between MED and traditional open surgery in terms of near and long-term results and complications, but its advantages such as small incision, short operation time, less bleeding, and early postoperative bed activity were increasingly appreciated. 3 %. In the last 30 patients, the operative time was reduced to 75 min, the average hospital stay was 7.7 h, and the average return to normal work and life was 17 days. Open surgery has a large incision, extensive stripping of the sacrospinous muscle, causing great damage to the paravertebral muscles and soft tissues, slow postoperative recovery, and long-term legacy of low back pain, while MED surgery has more advantages compared to it because of less damage and shorter time. Schick et al. found that the nerve root irritation in the MED group was significantly less than that in the open surgery group, and the electrodes were embedded in the corresponding nerve root innervated muscles of the lower extremities of MED patients and open surgery patients to record the nerve root irritation during surgery. The ischemic damage to the paravertebral muscles eventually leads to ischemic damage, which is correlated with lower back pain in postoperative patients. In contrast, MED surgery is performed in a small space with a working canal diameter of only 1.6 cm, resulting in minimal compression of the surrounding tissues, fine instrumentation, and a small range of motion, resulting in minimal tissue damage, The paravertebral muscles were found to be significantly atrophied in the open surgery group, while there was no significant difference between the preoperative and postoperative paravertebral muscles in the MED group.