Access selection for minimally invasive percutaneous discoscopic surgery Patients with herniated discs often require surgical treatment if conservative treatment is ineffective. Conventional open surgery mostly takes the posterior median open interlaminar approach. However, for minimally invasive percutaneous discoscopic surgery, there are various approaches, which need to be selected according to the patient’s specific situation. 1. Posterior interlaminar approach: For disc herniation of L5-S1, preoperative X-ray observation of the interlaminar space can be considered first if it is relatively wide. Through the dilatation tube, the nerve roots can be held outside the dilatation tube, and then the herniated part of the disc can be directly reached through the dilatation tube for surgical resection. This approach is the most direct, but has a certain failure rate. If the nerve root adhesions are severe and the patient has difficulty tolerating the nerve root pain, the surgery is difficult to proceed. It needs to be changed to a posterior lateral approach. 2.Posterior lateral foraminal approach: For disc herniation of L4-5, this approach can be used directly, especially for very lateral disc herniation. for disc herniation of L5-S1, the height of the iliac spine and the blockage of the transverse process should be considered, and preoperative X-rays of the lumbar spine and pelvis should be taken to evaluate. 3. Lateral approach: For central type of disc herniation, or severe disc herniation, a more lateral approach is often used in order to better remove the herniated disc, with the puncture point more outward, sometimes reaching the level. However, there is an increased risk of injury to the dural sac or intestinal canal. The position of the intestinal canal should be observed intraoperatively to avoid injury. In conclusion, there is no fixed route for different patients with different protruding sites, different severity, different fatness and thinness, and it can only be individualized to achieve safety and effectiveness.