With the increasing number of lumbar spine surgeries, many patients have been added with lumbar spine internal fixation nails after surgery, so when should internal fixation be done? First of all, let us understand that the role of lumbar internal fixation is to stabilize the spine, so when the patient has lumbar instability before surgery or the surgery will cause lumbar instability, then the lumbar internal fixation nail should be added. Usually a simple lumbar discectomy does not cause lumbar instability, so no internal fixation is needed. But why is internal fixation of the lumbar spine becoming more and more common nowadays? This has both doctor and patient reasons, the lumbar spine using internal fixation can avoid the recurrence of herniated discs in the operated segment, patients do not want to operate twice after surgery, and doctors do not want the recurrence after surgery to be mistaken by patients as a bad surgical technique, so they simply add internal fixation, and all are happy. However, internal fixation has its disadvantages, increasing the surgical trauma, increasing the cost of surgery, and most importantly, increasing the chance of recurrence of herniated discs in the vicinity of surgery. Therefore, for young people, internal fixation nailing should not be done at all for lumbar disc herniation, unless there is lumbar instability, because recurrence of the disc in the adjacent segment still requires secondary surgery. A month ago, a patient with a herniated disc in his 20s was admitted to our ward, and the doctor repeatedly told him that he did not need internal fixation surgery, but the patient just asked for “nail fixation”, and finally he got what he wanted. If I were a doctor, I would firmly refuse the patient’s request! I often let the patient misunderstand me because of this and I am very helpless!