Lumbar disc herniation is the most common clinical cause of back and leg pain. Fifteen to twenty percent of our manual workers suffer from this disease. Patients with lumbar disc herniation can exhibit a variety of clinical symptoms depending on age, gender, duration of the disease and the location of the herniation. In the past, removal of lumbar disc herniation was performed at home and abroad. However, with the progress of medicine, minimally invasive techniques suitable for different conditions as well as non-fusion techniques have gradually emerged. Many patients are afraid of conventional open surgery when conservative treatment does not work, and there is no doubt that minimally invasive techniques bring hope to these patients. In fact, each type of spinal surgery has its own indications and suitable population, and should be chosen according to the specific circumstances of the patient’s disease, the patient’s own claims, as well as the experience of the surgeon and the specific circumstances of the hospital. In recent years, different minimally invasive spine techniques have been the most active approach in each phase of treatment. Stage 1: Conservative treatment 80% of patients can get better with regular conservative treatment. Most patients with lumbar disc herniation can be treated conservatively and find relief. Formal conservative treatment methods include bed rest, traction, physical therapy, closed therapy and oral pain relief. Stage 2: Interventional treatment For patients who have failed conservative treatment after a long period of time (more than 3 months) and are unwilling to undergo surgery, interventional treatment can solve part of the problem. They include collagenase injection, ozone injection, radiofrequency, laser and plasma knife. In general, patients with mild symptoms, early lesions, MRI or CT examinations suggesting mild herniated lumbar discs, no free and prolapsed discs and no significant segmental instability present can be treated with percutaneous interventional therapy to achieve the therapeutic goal of relieving spinal cord and nerve compression and irritation. Interventional treatment is less invasive and early to get out of bed, but it is not effective in removing pressure-causing materials, and many cases relapse soon after a short period of relief, and the indications for treatment are narrow. The absolute indications for surgery are cauda equina damage and progressive motor dysfunction; the relative indications are patients with ineffective conservative treatment, temporarily effective conservative treatment but recurrent sciatica, obvious motor dysfunction, combined lumbar spinal stenosis, huge disc herniation, severe pain and difficulty in various positions. Surgical methods include minimally invasive foraminoscopic treatment and conventional surgery. 1.Minimally invasive intervertebral foramoscopy treatment Features (compared with traditional open surgery): surgical efficacy and complications are equal to or even better than traditional open surgery; shape, i.e., small skin incision (beautiful); small muscle damage (light postoperative pain and fast recovery); small impact on bone and joint (small impact on spinal stability); small ligament damage (small impact on postoperative stability); few sequelae, fast postoperative recovery and short hospitalization time. scientific treatment method. The fundamental difference with interventional treatment is that the nucleus pulposus of the intervertebral disc that protrudes into the spinal canal and compresses the nerve is removed directly under visualization using endoscopy, which is safer than open surgery. The procedure is performed under local anesthesia, and the patient can interact with the surgeon during the procedure. The wound is only 7mm and can be left unstitched. The herniated disc is removed under direct visualization through video magnification, making the surgery safe and reliable. Immediately after surgery, the patient feels relief from back and leg pain and has a negative straight leg raise test. Because this method is very minimally invasive and allows immediate bedtime activities, our hospital is now gradually adopting day surgery for treatment (hospitalization on the day of surgery and discharge the next day). 2, conventional surgery In the case of minimally invasive surgery such as intervertebral foraminoscopy cannot be carried out, conventional open surgery is still the most effective method for lumbar disc herniation. Conventional surgery includes open interlaminar opening, hemilartebral laminectomy, total laminectomy and other disc removal procedures, including microsurgery or conventional surgery under direct vision. Stage 4: Non-fusion technique Non-fusion fixation technique for lumbar disc herniation has strict indications and is generally considered to be indicated for patients with a mild degree of lumbar instability. Non-fusion technique is used to prevent further aggravation of instability, which preserves the motor function of the spine and is not applicable to cases with combined bone deformity, severe stenosis of the spinal canal requiring extensive decompression or the presence of severe slippage. Stage 5: fusion technique This is the most mature and most effective method, and is the ultimate treatment for lumbar disc pathology for cases with both lumbar instability and slippage, but at the expense of spinal motion function of the operated segment. In recent years, our hospital has adopted minimally invasive access to complete this surgery, which is gradually accepted by patients for less intraoperative bleeding, less postoperative pain, faster recovery (you can get out of bed the day after surgery) and shorter hospital stay than conventional open surgery. The “ladder treatment” for herniated disc is based on various factors such as the patient’s different pathological states, clinical manifestations and the patient’s general condition, and the application of advanced minimally invasive technology to select the most suitable treatment method for the patient, so as to relieve symptoms, achieve cure, early recovery and preserve function as much as possible. Different measures are used at different stages to avoid “one-size-fits-all” blind treatment.