Lumbar disc herniation is a common disease in orthopedic outpatient clinics and the most common cause of low back pain. Most patients can be relieved or cured after conservative treatment, but there are still 10% to 20% of patients for whom conservative treatment is ineffective. In recent years, with the rise of minimally invasive surgical concepts in China, minimally invasive surgical treatment of lumbar intervertebral disc herniation has gradually become a popular trend. This article summarizes the progress of minimally invasive treatment of lumbar disc herniation. First, percutaneous surgical techniques 1, nucleus pulposus chemolysis Nucleus pulposus chemolysis is the use of specific dissolving enzymes, the nucleus pulposus of the intervertebral disc of a certain component of the dissolution of the disc, so that the pressure in the intervertebral disc and the spinal canal is lowered; nerve compression has been reduced or lifted, thus relieving the symptoms. However, in the United States, chemical nucleus pulposus dissolution has been discontinued due to serious complications and lower therapeutic efficacy than standard discectomy. Therefore, its clinical value needs to be further verified, and it is rarely used in clinical practice at present. 2.Ozone Nucleus Pulposus Ablation Ozone has strong oxidizing ability, which can oxidize the proteoglycans in the nucleus pulposus, make the nucleus pulposus shrink and the annulus fibrosus retract, and relieve the nerve root compression; meanwhile, it also has anti-inflammatory and analgesic effects, which can improve the local inflammatory state, thus relieving or alleviating the symptoms of low back pain. Ozone nucleus pulposus ablation for the treatment of lumbar disc herniation is a safe, effective and less traumatic surgical procedure, and it is repeatable; if the clinical efficacy is not satisfactory, it can also be changed to intervertebral discoscopy or other surgical procedures, avoiding the limitations of the choice of surgical procedures after general surgery recurrence. The biggest disadvantage of this surgery is the high recurrence rate. 3.Plasma Nucleoplasty The main purpose of this procedure is to use low-temperature radiofrequency technology to change the intermolecular structure of the nucleus pulposus, prompting a decrease in intravertebral disc pressure, and at the same time eliminating some of the pain-causing neurotransmitters, so that the phenomenon of low back and leg pain induced by degenerative disc mutation can be effectively treated. The advantages of this treatment include easy operation, short operation time, good effect, no need for hospitalization, high safety and fast recovery. However, due to the limited decompression within the intervertebral disc, the symptoms can be relieved in the short term after the operation, but in the long term, the recurrence rate is high. 4, intravertebral disc electrothermal therapy Intravertebral disc electrothermal therapy, also known as intravertebral disc electrothermal fibrous annulus formation, its therapeutic principle is to make the collagen fibers in the fibrous annulus deformation and contraction of the local thermal therapy. The principle of treatment is that local heat therapy causes the collagen fibers in the annulus fibrosus to deform and contract, causing the tear to heal, and heat inactivates the nociceptive nerve endings distributed in the outer layer of the annulus fibrosus, causing it to lose the ability to receive and transmit pain signals. Indications are intradiscal rupture type discogenic low back pain with persistent low back pain for more than 6 months, ineffective conservative treatment, negative straight leg raising test, MRI not showing nerve root compression, and discography-induced pain exacerbation. Early studies proved it to be a safe, less complication, shorter hospitalization and effective surgical procedure. The disadvantage is that the placement of radiofrequency electrodes in the intervertebral disc is not visualized, and the volume reduction of the disc is limited by intradiscal ablation. Some articles have reported cauda equina syndrome due to intradiscal electrothermal therapy, so its efficacy needs further clinical observation. 5, percutaneous puncture disc extraction The mechanism is to partially excise the nucleus pulposus and suction it out, in order to reduce the pressure in the intervertebral disc and alleviate the stimulation to the nerve root and pain receptors around the disc, so as to achieve the therapeutic purpose. There are mainly manual lumbar disc removal (PLD), automatic lumbar disc removal (APLD), although the literature has proved that PLD, APLD is a simple operation, little damage, high safety, good efficacy of the treatment method, applicable to most of the lumbar disc herniation patients, but the actual clinical application of PLD has not yet been widely accepted and adopted, APLD’s negative reports of the impact of the large has also led to its However, PLD has not been widely accepted and adopted in practical clinical application. Endoscopic surgical techniques 1. Posterior fiber endoscopic discectomy This technique combines endoscopic minimally invasive technology with traditional open surgery, with posterior approach, using discoscopy to observe the status of the disc, and using annular forceps to cut the nucleus pulposus tissue. The indications are wide, LDH diagnosis is clear, after 3 months of systematic conservative treatment is ineffective; or the history of the disease is short, but the pain is severe, affecting the life and work, and there are signs of nerve root compression, can be used to treat this procedure. The surgery has the advantages of small damage, clear anatomy, fast recovery, especially in reducing the occurrence of postoperative adhesion, the excellent rate of up to 92.8%. 2.Intervertebral foramenoscopy technology The treatment principle of intervertebral foramenoscopy TESSYS technology is to remove the protruding or prolapsed nucleus pulposus and hyperplastic bone outside the intervertebral foramen safety triangle and intervertebral disc fibrous ring completely. The pressure on the nerve roots is relieved, eliminating the pain caused by nerve compression. The approach is mainly through the intervertebral foramen and enlarged to form the intervertebral foramen, so it is suitable for most types of lumbar disc herniation, and at the same time, it can effectively treat spinal stenosis and remove osteophytes. Compared with other minimally invasive techniques, it is currently the most minimally invasive surgical treatment, and is a new technology with great potential for development. Quadrant System The Quadrant System is an emerging surgical instrument in recent years. With the help of an expandable working channel, the Quadrant System can accurately reach the surgical area and complete the opening of the vertebral plate and removal of the nucleus pulposus under direct vision, with less trauma and quicker postoperative recovery. As long as the traditional posterior surgery can be completed, almost all the lumbar disc herniation can be completed under the Quadrant minimally invasive access. In particular, interbody fusion under Quadrant access allows the surgery to be closer to open surgery while retaining the minimally invasive features, with more definitive surgical results. However, the application of Quadrant minimally invasive system for postoperative recurrent disc herniation should be cautious, as it may be safer to choose traditional open surgery due to severe local adhesions. In summary, minimally invasive surgery for lumbar disc herniation has the advantages of less trauma, less bleeding, faster recovery, and fewer complications, and with full mastery of its indications, it can achieve a greater rate of excellence and is the direction of future development. Since percutaneous intervention is not visualized, fails to decompress completely, and has a high postoperative recurrence rate, orthopaedic applications are relatively few, and endoscopic or Quadrant channel surgical treatments are preferred for lumbar disc herniation. With the development of minimally invasive concepts, minimally invasive instruments and the accumulation of clinical experience, the efficacy of minimally invasive techniques will be better and the scope of application will be further expanded.