Lumbar spine disorders (lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis) step therapy Keywords lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis Treatment, minimally invasive Lumbar spine disorders include lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis, etc. Many patients have been treated conservatively for many years, but their symptoms cannot be relieved and they are in great pain, so they go to the hospital and their doctors recommend considering surgery. The purpose of surgical treatment is to remove the herniated disc so that the compressed nerves can regain free space; expand the spinal canal space and reset. However, traditional surgery is very traumatic and inappropriate for the elderly, and many patients with lumbar spine disease desire an ideal method that is less traumatic, less painful, quicker to recover, more effective, safer and simpler. In 1998, Professor Anthony Yeung (Chairman of American Minimally Invasive Surgery) pioneered the YESS technique; in 2002, Professor Hoogland (former Chairman of European Minimally Invasive Surgery) proposed the THESSYS technique on the basis of the YESS technique, which made the intervertebral foraminoscopy technique mature. It made minimally invasive treatment of lumbar disc herniation a reality. We propose a stepwise treatment plan for the treatment of lumbar spine diseases. Our principle in dealing with lumbar spine diseases is: never operate if you can; if you must operate, try to be minimally invasive and never expand. We believe that the majority of patients can be treated conservatively, and surgery will only be performed when conservative treatment is ineffective. When choosing a surgical method, we first consider minimally invasive surgery, and then consider conventional open surgery if minimally invasive surgery is ineffective or not possible. We are now carrying out the following minimally invasive surgical methods: 1. Minimally invasive interventional techniques 1) intervertebral disc radiofrequency/plasma/ozone/laser ablation; 2) intervertebral discography. It is performed under local anesthesia with a small needle pierced into a small joint or disc, followed by imaging, radiofrequency, plasma, ozone or laser ablation operations. These methods are relatively simple, low-risk and minimally invasive, and you can go home the same day after the operation. 2, minimally invasive treatment of spinal disorders: intervertebral foramoscopy technology Intervertebral foramoscopy technology uses local anesthesia, it is only 0.7cm in size, and only one stitch or even no stitch is needed after surgery, it destroys less stability of the spine, and patients can walk on the ground in 2-6 hours after surgery and can be discharged on the same day. However, the operating technique of foraminoscopy is more demanding, and its indications are narrower than discoscopy, and the recurrence rate is relatively high. The indications for foraminoscopy vary depending on the experience of the surgeon, and it is suitable for the treatment of most patients with disc herniation. 3, minimally invasive treatment of spinal disorders: intervertebral discoscopy (MED) technology The intervertebral discoscopy technology, or MED, involves making an incision of about 2 cm in the lumbar back, then inserting a 1.8 cm diameter endoscopic tube into the lesion site of the spine, and operating on the lesion site with the help of the endoscopic light source and imaging equipment. The intervertebral mirror technique can treat lumbar disc herniation, lumbar spinal stenosis, mild lumbar spondylolisthesis and lumbar instability, as well as cervical spine diseases, and it has a wide range of indications. The intervertebral discoscopic surgery is performed with semi-anesthesia, and the patient only needs about 2 stitches. The postoperative pain is very mild and the recovery is fast, and the patient can generally be bedridden for 3-7 days after surgery and can return to work in about 3 weeks.