Indications for minimally invasive disc surgery I. Absolute indications 1. Cauda equina syndrome, urinary and fecal incontinence. Acute large disc herniation causing urinary and fecal dysfunction is often free and needs immediate surgical removal for the best prognosis. 2. Progressive aggravation of neurological impairment, progressive nerve damage, lower extremity muscle weakness and sensory dullness, it is wise to intervene early to remove the herniated nerve-compressing disc. Second, the relative indications 1, conservative treatment is ineffective. This is the most common reason for surgery for lumbar disc herniation. Ideally, the course of conservative treatment should not be less than 6~10 weeks but not more than 3 months, and the treatment includes bed rest, Chinese and Western medicines, physical therapy, and various soft tissue treatments. The key to measuring the effectiveness of conservative treatment “is not only to relieve the patient’s pain, but also to improve the ability to raise the straight leg”, if the patient continues conservative treatment after 2~3 days of comprehensive conservative treatment without significant improvement in symptoms, the course of treatment may be very long, and at this time there is an indication for surgery, in order to avoid In order to avoid “chronic pathological changes in nerve root development”, surgical intervention for patients with acute nerve root symptoms is recommended within 3 months after the onset of symptoms. 2.Recurrent sciatica is determined to be caused by disc herniation, and surgical intervention is recommended to avoid “chronic neuropathic changes”. 3. Significant nerve damage accompanied by a significant decrease in straight leg raising is a widely used indication for surgery in the neurosurgical specialty. Although Weber and others have noted that “these patients will eventually recover using non-surgical approaches,” with the continued advances in minimally invasive spine techniques, “the harm and cost to the patient of completing the removal of a simple lesion protrusion is even less than that of long-term conservative treatment. ” and surgery can be done even on an outpatient basis. The chances of recovering neurological dysfunction in patients with surgical intervention will be higher. In addition, many patients in this category have severe pain and are often unwilling to tolerate conservative treatment to make it work and opt for surgery. In rare cases, patients will experience gradual improvement in pain with conservative treatment, but the neurological dysfunction will gradually worsen, and if MRI suggests a large prolapse, surgical treatment should be chosen at this time. 4.The ruptured disc enters the spinal canal, there is MRI suggesting combined spinal stenosis, and the nerve damage is related to this, surgical intervention is recommended. 5.Recurrent symptoms of neurological impairment are confirmed to be related to the protrusion of a large disc into the spinal canal, and surgical intervention is recommended.