In the past two weeks, our Orthopaedic Department, Area V, has consecutively received five cases of special lumbar disc herniation patients. Using the latest German Joimax endoscopy to operate independently, the endoscopic minimally invasive removal of the nucleus pulposus of these five special cases was successfully completed, which not only quickly solved the patient’s pain, but also maintained the stability of the lumbar spine at the same time. The special features of these five cases are as follows: Case 1: The patient is a patient with lumbar 2-3 high level disc herniation, which is relatively rare compared to the common lumbar 4-5, lumbar 5-sacral 1 level herniation, and the high lumbar vertebral canal is dense with the cauda equina, close to the spinal cord rounded vertebrae and spinal cord fluctuation is strong, and the intradural space is small, so a slight inadvertence will have the possibility of injury to the cauda equina. After accurate positioning and patient operation, the patient overcame the difficulty of active bleeding due to increased blood pressure after tension during the operation, and the herniated nucleus pulposus of the lumbar 2-3 intervertebral disc was successfully removed, which relieved her leg pain symptoms. Case 2: The patient was a lumbar 4-5 disc herniation patient with spinal stenosis after multiple surgeries, who had undergone semispinal decompression nucleus pulposus removal four years ago, as well as percutaneous laser treatment four weeks ago, but his symptoms were still not relieved. During the surgery, the surgeon talked and interacted with the patient to eliminate his fear of multiple surgeries, while carefully separating adhesions and anatomical changes caused by previous surgeries microscopically, removing the giant disc tissue in pieces, and removing the thickened ligamentum flavum microscopically to widen the narrowed neural root canal. At the end of the surgery, the patient was thrilled with a full recovery. Case 3; The patient came to our hospital from abroad to undergo transforaminal minimally invasive treatment for lumbar 5-sacral 1 disc herniation. However, while waiting for the surgery, the symptoms suddenly changed and the cauda equina nerve compression symptoms appeared. After MRI examination, it was found that the protruding disc on the left side had completely prolapsed and jammed into the central spinal canal, squeezing the spinal cord into the right side, which undoubtedly made the planned transforaminal lumbar 5-sacral 1 foraminotomy on the left side impossible. With Prof. KRZOK, a famous German intervertebral foramina expert, at the National Orthopaedic COA Annual Meeting, the surgeon drew on the new plan introduced by the German expert at the just-concluded National Orthopaedic Annual Meeting, and boldly attempted to use the Joimax endoscopy to enter the intervertebral canal through the posterior intervertebral space of lumbar 5-sacral 1 and skillfully use the under-scope instrumentation, avoiding the dural sac and the nerve root, and successfully removed the huge prolapsed intervertebral disc, and the surgery ended. The patient recovered immediately. This operation has only been carried out by Asia-Pacific Spine Minimally Invasive Center of Chongqing Xinqiao Hospital and Beijing 301 Hospital this year. Case 4: In another case, a patient with acute prolapse of lumbar 5-sacral 1 intervertebral disc was referred to our department from Xiamen, with pain in his right leg and inability to walk, and MRI suggested that the lumbar 5-sacral 1 intervertebral disc was completely prolapsed, blocking the spinal canal. The doctor used Joimax endoscopy to enter the spinal canal through the posterior intervertebral plate space of the lumbar 5-sacral 1 intervertebral disc again, and successfully removed the huge prolapsed nucleus pulposus, which relieved the pain of the patient, and the patient felt free and happy immediately. The above four cases were all completed under local anesthesia, the incision was only 0.7CM, lasted more than 2 hours, and the bleeding was less than 5ML. All of the patients were relieved of their symptoms as usual at the first time after the operation, and were discharged from the hospital three days later on a normal walk. Case 5, the patient was suffering from lumbar 4-5 disc herniation on the left side and left leg pain. Preoperative examination revealed that the patient was suffering from neck, shoulder and arm pain on the right side at the same time, and MRI suggested that the cervical 4-5 and cervical 5-6 discs were herniated on the right side, so we decided to carry out cervical and lumbar minimally invasive intervertebral disc surgeries at the same time. Nucleus pulposus removal was performed through the left lumbar foramen with Joimax endoscopy. The operation took less than 3 hours and the patient was able to solve the symptoms of both upper and lower extremities at the same time.