Lumbar disc herniation and lumbar instability with minimally invasive lumbar discectomy and internal fixation with intervertebral bone graft fusion pedicle nail rod system. The patient was admitted to our hospital with 10 years of lumbar and leg pain, aggravated for 1 year, with numbness in the lateral right calf and lateral dorsum of the foot, soreness and weakness in the lower limbs when walking, and unable to engage in physical work. We performed lumbar decompression, discectomy, intervertebral bone graft fusion and internal fixation with an arch root nail system under the paravertebral muscle access tube, and after the operation, the lumbar pain was relieved, and he could get out of bed in one week and engage in daily activities in three months. For patients with combined lumbar instability or spinal stenosis, decompression, fusion, and fixation surgery has a definite effect and a low recurrence rate. The minimally invasive surgical method has less stripping of the paravertebral muscles and less disturbance to normal tissues, but can perform exactly the same surgical operation as traditional surgery, and the surgical effect is better than that of traditional surgery, especially for patients with single stage and lumbar spine diseases within 2 segments.