Minimally invasive spine surgery (MISS) is performed through a tiny incision with special surgical instruments. Theoretical advantages: less tissue stripping; less postoperative pain; shorter hospital stay; less bleeding; earlier functional recovery. The main features are imaging, microscopy, endoscopic hollow screw technique, tubular retraction device, fiberoptic illumination and image navigation. With the aid of these techniques, many traditional spine surgeries can be performed in a minimally invasive manner, but they cannot replace all spine surgeries. Strict control of indications is the most critical factor for successful surgery, and selecting the right case remains the most challenging aspect of spine surgery today. The following lessons have been learned from 10 years of spine surgery: Be familiar with the anatomical adjacencies. Experience in open surgery as a foundation; strict mastery of the indications and contraindications for various minimally invasive techniques; a steep learning curve process; familiarity with the management of various complications; and good communication skills with the patient. Minimally invasive spine has certain risks and difficulties: different degrees of nerve and spinal cord injuries, vascular and dural injuries with serious consequences for the patient; obese patients and revision surgery, complicated complications; steep and time-consuming learning curve; prolonged operative time; unavoidable exposure to X-rays. All of the above have affected the application and development of minimally invasive techniques in spine surgery. Our spine surgery team has risen to the challenge and carried out: endoscopic techniques; canal expansion and decompression techniques; percutaneous fixation techniques; and vertebroplasty techniques. We are at the forefront of the province. Spine ten years to sharpen a knife, nerve spinal cord sheath on the carving, unblocking nerves to relieve numbness and pain, dilation of the spinal canal to see three effects. (In 2009, we started the full endoscopic spine surgery, which is the removal of lumbar disc through the intervertebral foramen/intervertebral plate approach. The indications for surgery are: age below 50 years; short onset (or initial onset), within 3 months; lumbar disc herniation (not prolapsed and free). MED (discoscopy) for lumbar disc herniation MED method: clear microscopic exposure of the spinal nerve roots, complete removal of the disc, safe, effective, short hospital stay, and readily accepted by the patient. Preoperative MRI Intraoperative discoscopic removal of disc nucleus pulposus Surgical wound Good recovery on the first day after surgery Transvertebral foraminal approach + radiofrequency ablation for disc herniation Preoperative MRI Surgical instrumentation Intraoperative puncture Surgical wound Removed disc nucleus pulposus Symptoms disappeared after surgery, straight leg raising test was normal II. For elderly patients with osteoporotic fractures and simple vertebral compression fractures without intracanal occupancy and spinal neurological symptoms, percutaneous internal fixation with pedicle screws is performed on the vertebral segment to be fixed under X-ray surveillance. Intraoperative visualization and fluoroscopy Postoperative wound III. canal expansion system Canal expansion system + optical endoscopic system (Quadrant technique), through the multifidus intervertebral foramen approach, removal of the herniated nucleus pulposus and extreme lateral disc, simultaneous nailing of the upper and lower vertebral segments and intervertebral fusion (commonly known as TLIF technique). Fourth, vertebroplasty simple osteoporotic vertebral compression fracture, vertebral hemangioma, elderly vertebral metastases, posterior convexity deformity after vertebral fracture can be used PVP and PKP techniques. PVP simply uses bone cement to infuse the injured vertebrae, PKP uses balloon expansion and then infusion of bone cement to fill, both can enhance the height and strength of the injured (diseased) vertebrae and provide immediate pain relief. Cervical 3 vertebral hemangioma via anterior cervical PVP Preoperative MRI Intraoperative puncture localization Postoperative X-ray fluoroscopy Osteoporotic fracture PKP (Kumml’s disease) Preoperative MRI film Intraoperative postoperative fluoroscopy By Huang Xiangwang Liu Hongzhe Editor’s note: The Orthopedic Medical Center has 260 beds and four subspecialties: spine, traumatic bone disease, joint surgery and pediatric orthopedics. Under the leadership of Huang Xiangwang, director of the Orthopedic Medical Center, the subspecialties have developed significantly along the development trajectory set by the Orthopedic Medical Center. The spine is developing minimally invasive surgery, trauma orthopedics is developing the diagnosis and treatment of peripheral nerve disease, bone disease and vascular muscle flap transplantation, joint surgery is developing sports medicine, pediatric orthopedics is developing pediatric anesthesia and cerebral palsy orthopedics, and in 3-5 years the Orthopedic Medical Center will develop 7~8 independent medical care units. At present, the spine surgery team speaks of unity, seeks development, works in an orderly manner, and continues to expand along the direction of the medical center development plan. Since moving to the new building, the inpatient bed capacity is over 100% and the volume of surgery has increased significantly.