Lumbar intervertebral disc herniation is a syndrome manifested by degeneration of the intervertebral disc, rupture of the annulus fibrosus, and protrusion of the nucleus pulposus tissue that irritates and compresses the nerve root and cauda equina root. 1.Symptoms (1) lumbago: lower lumbar sensory pain produced by the stimulation of the outer layer of the annulus fibrosus and the posterior longitudinal ligament by the protruding nucleus pulposus via the sinusocele nerve, affecting the buttocks. (2) Sciatica (L4/5.5/sacral 1 interspace protrusion) Typical manifestations: radiating pain from the lower lumbar region to the buttocks, the back of the thighs, the lateral calf and up to the foot. (3) Cauda equina compression: urinary and faecal disorders, abnormal sensation in the saddle area. Diagnosis (1) Symptoms; (2) Signs; (3) X-ray film, CT and MRI can make the diagnosis. The disease should not be diagnosed only by CT and MRI without clinical symptoms. 3.What kind of lumbar disc herniation needs surgical treatment? (1) Acute attack with obvious cauda equina symptoms. That is, the patient suddenly develops severe sciatica, sensory impairment, dysfunction of urinary and fecal functions, and needs urgent surgery to remove the intervertebral disc. (2) Those with obvious diagnosis: those who are ineffective with regular and systematic non-surgical therapy should receive surgical treatment to alleviate the pain. (3) Recurrent symptoms: Some patients with significant symptoms, which are relieved by non-surgical treatments and then flare up again in less than 6-8 weeks, and their daily life is seriously affected, may consider surgical treatment. (4) Gradual progression of the disease and obvious neurological symptoms. If the patient’s condition is aggravated, with weakening of muscle strength, persistent numbness in the innervated area or even foot drop, signs of nerve damage appear on physical examination, and the condition of nerve root compression in combination with CT, imaging and other examinations is consistent with the symptoms, surgery should be carried out as soon as possible. (5) Combined with other causes of lumbar spinal stenosis, patients who need to undergo spinal canal surgical exploration.