Low back pain is common in China, and there are few adults who have not suffered from low back pain. Some people come to the hospital with severe low back pain or with radiating pain in the lower extremities, and after a series of tests, a herniated lumbar disc is discovered. In general, open surgery involves making a 3-5 cm skin incision in the back at the appropriate surgical site, then cutting deep into the back muscles to reveal the vertebral plate, then biting a small window in the plate with a special instrument to reveal the spinal canal and nerves, then going in and pulling the nerves apart to reveal the herniated disc below, then removing the disc, and finally suturing the tissue layer by layer to end the surgery. The procedure is completed by suturing the tissue layer by layer. The entire procedure is performed under continuous epidural (hemi-anesthesia) or general anesthesia. Discoscopic surgery is actually a scaled-down version of open surgery. It requires only a 2 cm incision, then a working tube is placed on the surface of the vertebral plate and the subsequent steps are the same as for open surgery: opening of the vertebral plate – distraction of the nerve – removal of the disc – suturing of the tissue – end of the procedure. -suturing the tissue – ending the procedure. The entire procedure is also performed under continuous epidural anesthesia (hemi-anesthesia) or general anesthesia. There are two approaches to laminectomy, one from the lateral aspect of the back and one, like discoscopy, from the posterior aspect of the back. Either way, the herniated disc site is accessed directly by puncture, and a working canal is gradually established through which a coaxial endoscope is placed with a diameter of about 0 or 6 cm to observe the situation in the spinal canal under direct endoscopic vision and remove the herniated disc tissue. Since the working tube is only 0.6 cm in diameter, the surgical incision is only about 0.6 cm, which basically protects all the tissues outside the disc and minimizes additional damage to the body. The entire procedure can be performed under local anesthesia. For the above three surgical methods, they can be briefly summarized as follows (of course not applicable to all cases): 1. Open surgery can basically be replaced by discoscopic surgery. Because the two principles are the same, and the latter is less traumatic. 2. If you can choose foraminoscopic surgery, you should not choose discoscopic surgery. Because the damage of foraminoscopic surgery is much less than discoscopic surgery, many patients’ pain disappears immediately after surgery and they can walk on the ground immediately, which can rarely be achieved after discoscopic surgery. 3. Not every patient with disc herniation can undergo foraminotomy, and some patients with herniation with calcification or severe stenosis of the lumbar spinal canal are not suitable. The specific situation needs to be judged by the doctor. 4, open surgery and discoscopic surgery can remove part of the disc that has not yet herniated, which reduces the probability of re-herniation of the disc. Foramenoscopic surgery is difficult to remove both the herniated disc and the unherniated disc because of the small canal, so the recurrence rate of herniation should be slightly higher than that of open surgery and discoscopic surgery. That said, the disc has an important physiological function, and removing more will lead to accelerated narrowing of the intervertebral space and premature aging of the lumbar spine, which is the root cause of many age-related back pains. Therefore, the medical community has not yet decided whether to cut the unprotruded discs or not, and how much to cut. Our view is that the least invasive method should be used to solve the problem. We will try to use the least invasive method to solve the problem, not discoscopy if we can, and not open surgery if we can. If only the protruding discs that cause symptoms are cut, if they are cured from then on, that is the best result; if they recur, then the least invasive method of surgery is chosen again (the more minimally invasive the surgery, the less impact on the human body when repeated), and the possibility of curing remains high; if it is not effective, then the surgery is upgraded to a more invasive one until the corresponding good results are achieved.