Patient: 2009 sudden onset of back and leg pain, with black ointment cure, February 2012 ~ ~ ~ ~ now back and leg pain extends to the middle of the calf area trunk, walking more comfortable, but it is difficult to sleep at night. March 16, 2012 in this hospital radiofrequency thermo-coagulation target point, there is an improvement, the night can sleep, discharged from the hospital open mouth medication to go home and recuperate. 2012 May 9 leg pain aggravation, walking occasionally one side tilt pain is intolerable, and do a radiofrequency thermo-coagulation target point, ineffective, the hospital suggests that the open surgery! Can you give some treatment suggestions? How effective is minimally invasive herniated disc surgery? Forgot to add: MRI diagnosis: lumbar degenerative osteoarthropathy, lumbar spine instability, lumbar 5|sacral 1 cone gap stenosis, end plate inflammation, lumbar 3|4,4|5 disc bulge. Doctor: I suggest you take the mri with a camera and pass it on. Young people’s low back pain, often simple disc herniation, early can be minimally invasive surgery, sudden larger open surgery. But the elderly disc herniation is often combined with spinal stenosis and osteophytes, minimally invasive effect is not good, repeated attacks. Open surgery or even internal fixation is needed. You can refer to the articles in my website in this regard Patient: Hello, Dr. Ma! As soon as I uploaded the image , please take a look at it in your busy schedule and give some advice! Doctor：Already seen, from the film is predominantly lumbar spinal stenosis, L3/4 and L4/5 obvious. To tell you the difference between a herniated disc and spinal stenosis: a herniated disc often refers to a segment, and in the early stage, only a little bit of protrusion, you can use minimally invasive treatment. If the herniation is more, minimally invasive can not take clean, easy to recur. Moreover, the herniated disc will closely press against the nerve root, and radiofrequency or ozone or collagenase may even injure the nerve by mistake, so minimally invasive is not advocated at this time. If there are 2 to 3 segments of herniated discs, and they are heavy, they cause symptoms not only compression of the nerve, but also cause narrowing of the volume of the spinal canal and increased pressure, which is called spinal stenosis. In the elderly, there is also some osteophytes and mild spondylolisthesis. These are not solved by minimally invasive. So the best indication for minimally invasive is young people, herniated discs, in the early stages. If the elderly are usually in good health, open surgery is indeed recommended, and the specific surgical method is spinal canal decompression + pedicle screw internal fixation. If there are no complications, the results are pretty good. If you don’t have time for surgery, you can have conservative treatment first. Besides hot compresses and plasters, you can take some Chinese medicines such as strong bone capsule and Tongdi capsule orally. I wish you a speedy recovery!