The concept of minimallyinvasivesurgery (MIS) was first introduced by British surgeon Wickham in 1983. So what exactly is the meaning of minimally invasive surgery? First of all, minimally invasive is a concept, which refers to reducing the disturbance and damage to normal tissues during surgery, reducing the trauma of surgery, including smaller surgical incisions, protecting normal tissues such as nerves and blood vessels, stopping bleeding completely, etc. It is the operating concept that surgeons follow; secondly, minimally invasive is a technology, which is the use of improved or new high-tech technology to achieve the purpose of minimal or no trauma. Modern minimally invasive technology has reached a high level, such as the widespread use of endoscopic technology, arthroscopy, laparoscopy, thoracoscopy, etc. Many traditional surgeries have been replaced by minimally invasive surgery; thirdly, minimally invasive is a new development direction in the field of surgery. Minimally invasive has been widely used in almost all disciplines of modern surgery, and it will definitely dominate the field of surgery in the future; fourth, minimally invasive has become an emerging industry chain in today’s medical world, and it will continue to flourish in the future. I will now present an overview of minimally invasive procedures in the field of orthopedic spine. From the perspective of clinical application, we classify minimally invasive spine technologies into the following four categories: the first category is applied to intervertebral discs, mainly lumbar disc herniation and cervical disc herniation; the second category is applied to lumbar spinal stenosis, and the most classic technology is the “access technology”, which means that conventional open surgery is done through an expandable tube with special The third category is for spinal fractures, which is the vertebroplasty technique; the fourth category, which we classify as other categories, includes minimally invasive techniques for spinal orthopedics, spinal tuberculosis, and spinal tumors. The incidence of disc herniation is very high, and many people are clinically diagnosed with “disc herniation”, and minimally invasive treatment for lumbar disc herniation is the earliest and most widely used in clinical practice. Minimally invasive techniques include: ozone injection, collagenase lysis, percutaneous laser nucleus pulposus decompression, radiofrequency targeted ablation, low-temperature plasma radiofrequency ablation, percutaneous excision and suction, discoscopic discectomy and foraminoscopic discectomy. Does it look too complicated? I will introduce to you the principle of each procedure, advantages and disadvantages and indications for clinical application. 1, ozone injection ozone injection, as the name implies, is to inject ozone into the herniated disc to oxidize the proteoglycans of the nucleus pulposus tissue through the oxidation effect, destroying the nucleus pulposus cells and then being absorbed, thus playing the purpose of decompression. The percutaneous puncture is minimally invasive, however, the effect is slow and takes 6-8 weeks. Postoperative bed rest is required. It is mainly used clinically for early inclusive disc herniation. 2.Collagenase lysis uses biological enzymes (collagenase and papain) to dissolve the nucleus pulposus and fibrin to achieve the purpose of decompression. The postoperative effect is slow, requiring 6-8 weeks of bed rest, and is also used in the early stages of inclusive disc herniation, with occasional strong allergic reactions. 3. Percutaneous laser nucleus pulposus decompression is performed by cauterizing the nucleus pulposus through the thermal coagulation effect of the laser, which operates at a temperature higher than 100°C (1.3 mm outside diameter of the working sleeve needle), and the disc is cauterized and then absorbed through necrosis to achieve the purpose of disc decompression. The pain of the procedure is more obvious, and strict bed rest is required for 6 weeks after the procedure, and the same clinical use is mainly for early inclusive disc herniation. 4, radiofrequency target ablation its principle of action is radiofrequency thermal effect, working temperature is greater than 100 ℃, puncture needle diameter 0.7 mm, after treatment disc tissue through late necrosis absorption to achieve the purpose of decompression. The pain of the procedure is more obvious and requires strict bed rest for 6 weeks after the procedure, and the same clinic is mainly used for early inclusive disc herniation. 5, low-temperature plasma radiofrequency ablation This technology is currently considered the most reliable, least side effects and most positive clinical effect of minimally invasive disc puncture technology. The working principle is to launch the plasma ring in the intervertebral disc to vaporize the nucleus pulposus and the fibrous ring directly, the working temperature is 40-70℃, the ablation range is 12mm, the treatment effect is achieved immediately after the operation, no bed rest is needed, and the patient can be discharged after the operation. 6.Percutaneous excision and suction works by direct puncture of the needle into the intervertebral disc, cutting open the skin, and inserting a thicker tube into the disc by enlarging the orifice layer by layer, and the surgical instrument directly removes part of the nucleus pulposus tissue. As long as the surgical indications are chosen correctly the clinical results are certain and are adapted to early inclusive disc herniation. Complications are few, and the patient can be discharged the day after surgery. The discoscopic technique has been used for a long time and is still the main means of treating herniated discs. 2004 was widely carried out in China, and the principle of surgery is almost equivalent to direct surgery to remove the disc, with a smaller incision than direct resection, about 2.5-3 cm. General anesthesia or hemi-anesthesia (lumbar anesthesia or continuous epidural). The clinical results are positive and more widely used, adapted to almost all types of disc herniation, and can be discharged 3-5 days after surgery. 8, intervertebral foraminoscopy technology intervertebral foraminoscopy technology is currently considered the most minimally invasive surgical technique. Local anesthesia makes it possible to operate on many patients with age-related diseases who would otherwise be inoperable; moreover, the patient reacts when the nerve is touched during the operation, which makes the operation much less risky; the lateral puncture into the foramen reduces interference with the spinal canal (i.e., reduces interference with other nerves); and the operation is performed as a surgical procedure. The operation is performed under endoscopic surveillance (close to direct vision), which makes the operation safe and effective; the incision is very small, only 8 mm, and the damage to the body during the operation is minimal, and the patient can walk on the floor after the operation. The incision is very small, only 8mm, and there is minimal damage to the body during the operation.