For the specialist, minimally invasive is a concept, not simply the size of the incision, but the principle of protecting as much normal tissue as possible throughout the treatment process. For the surgical treatment of lumbar degeneration, preoperative examination, history taking, weight-bearing dynamic radiographs and MRI, combined with lumbar spine imaging if necessary, are used to clarify the responsible disc and compressive nerve roots, and to select the appropriate scope of surgery, taking into account the patient’s age, work and life needs, and to preserve the lumbar motion segments as much as possible. For young patients with lumbar disc herniation, because there is no lumbar instability, unilateral access to the lamina is often taken to open the disc, remove the nucleus pulposus and decompress the nerve roots. The advantages are rapid recovery, less bleeding, and early mobility to the floor. Most of the operations use unilateral exposure to deal with the responsible segment and complete decompression of the nerve roots, preserving as much as possible the small joints, contralateral small joints, muscles, and posterior tension band structures. In patients with lumbar disc herniation, decompression, interbody graft fusion (1 fusion), and unilateral nail bar fixation (preoperative power position film to assess stability, and intraoperative lifting of the nail bar to confirm post-fixation gap stability) are performed from the symptomatic side; in patients with lumbar spinal stenosis, full plate decompression is performed unilaterally, and if there is instability, interbody graft fusion and unilateral nail bar fixation are performed. The advantages are: 1. no significant difference with bilateral fixation in terms of stability; 2. preservation of contralateral muscles, small joints, and posterior tension band structure, less injury, less bleeding, and favorable postoperative rehabilitation; 3. alleviate the economic burden of patients.