Therapeutic ladder Category of methods Specific methods Self-prevention Health education Second stage Conservative treatment Medication Rehabilitation Third stage Minimally invasive intervention Intervertebral discography Small joint injection/damage Radiofrequency/plasma/ozone/laser ablation Fourth stage Minimally invasive surgery Intervertebral foramenoscopy Posterior endoscopy (MED) Endoscopy plus ablation Minimally invasive fusion Fifth stage Conventional surgery Open endoprosthesis Revision surgery Implications of the ladder of spinal disease treatment: Tongji 10th Hospital divides the treatment measures of spinal diseases into five stages according to the trauma from small to large: self-prevention → conservative treatment → minimally invasive intervention → minimally invasive surgery → traditional surgery; the treatment of spinal diseases should follow the principle of gradual step-by-step laddering, usually patients should try to start from the minimally traumatic self-prevention when choosing the treatment method, and consider the more traumatic treatment measures only when the minimally traumatic ones are ineffective. Only when less invasive treatments are ineffective should more invasive treatments be considered. At the core of the spine treatment ladder is the participation of both the doctor and the patient, with the goal of optimizing efficacy and minimizing trauma, to discuss and develop a treatment plan that is best suited to the patient’s needs.