1, the principle of disc herniation treatment: disc herniation is a lumbar degenerative process, disc herniation compressing nerves to produce symptoms, most patients after conservative treatment (such as bed rest), the pain symptoms can be relieved. As the body ages, degeneration shows a tendency to become more and more severe. Degeneration and aging are inevitable trends in the life course. Herniated discs are progressive diseases and cannot be completely cured or treated in one step. The first is the principle of ladder treatment: it is to try to use less invasive methods of treatment according to different ages and different degrees of herniation and degeneration. The second is the principle of minimally invasive; that is, try to use the least invasive method without affecting the efficacy. Stepped treatment principle: for the population, the sequence of stepped treatment is: conservative treatment, interventional treatment (ozone, condensation vaporization, laser), minimally invasive treatment (endoscopic surgery, MED surgery, small incision surgery, minimally invasive fusion surgery), and open surgery. There are certain indications for any procedure and it is not necessary to try each one in this ladder for each patient. The most appropriate method should be chosen according to the individual condition. The benefits are directly proportional to the risks. Conservative treatment has low risk, low efficacy and high recurrence rate. Open surgery has high risk, good efficacy, and low recurrence rate. Interventional and minimally invasive methods are in between. 2. Principles of choosing conservative treatment: (1) Most low back pain can be treated conservatively. Unless there are serious imaging changes, such as severe lumbar instability and slippage, simple low back pain can be treated conservatively. (2) If there are no cauda equina symptoms, most low back pain can be treated conservatively. (3) If pure pain most can be treated conservatively, if combined with numbness and weakness, caution is needed. (4) Imaging is not severe for low back pain, leg pain or low back pain. (3) Principles for choosing surgical treatment: (1) Irrespective of the presence or absence of low back pain, there is intolerable radiating leg pain (sciatica). (2) The pain is not very serious, but it is very disturbing to life and work, combined with serious imaging changes. (3) Low back pain, leg pain, or low back pain with severe imaging changes that have failed to respond to conservative treatment. (4) Sciatica with a very clear localization and insignificant imaging changes. Trial of closed therapy is needed to find the cause of pain. In the past, the duration of conservative treatment for lumbar disc herniation was 6 months. With the development of imaging and treatment experience, the judgment of the efficacy of conservative treatment has become more accurate. Currently, it is generally 3 months. 4. Combination of imaging and clinical symptoms with each other: severe symptoms + severe imaging = surgical treatment, not severe symptoms + severe imaging = conservative treatment or surgical treatment, not severe symptoms + not severe imaging = conservative treatment 5. Surgical treatment of lumbar disc herniation: with the help of traditional surgical instruments, incision of skin, separation of soft tissue and bone to reach the herniated disc is the traditional meaning of disc herniation Surgical treatment of disc herniation. After conservative treatment, or after interventional or minimally invasive treatment, patients who are not satisfied with the relief can perform surgical treatment. 6. Surgical treatment of lumbar disc herniation: interventional techniques are mainly carried out by pain and interventional physicians, and neurosurgeons carry out the following methods: spinal endoscopic surgery (PELD), discoscopic surgery (MED), mini-opening surgery, hemivertebral laminectomy, total laminectomy, trans-laminar interbody fusion (mini-TILF) with small incisions, conventional TLIF, conventional total laminectomy fusion (PLIF), anterior approach lumbar fusion (ALIF), and lateral approach interbody fusion (DLIF, XLIF). The choice of procedure is based on the patient’s condition, hospital conditions and the surgeon’s proficiency. Our neurosurgery spine and spinal cord group has been engaged in various lumbar spine surgeries for a long time, and we can perform most of the above-mentioned procedures skillfully, so we welcome patients to come to us. 7. The indications and contraindications for posterior surgery are suitable for patients with spinal stenosis, nerve root canal stenosis, ossification of the posterior edge of the vertebral body, herniated discs in the thoracolumbar segment and other types. Contraindications are relative and there is no clear contraindication. 8, common complications of posterior surgery and its prevention of nerve root and dural sac injury, incomplete disc removal, etc. Preoperatively, careful extraction of the patient’s medical history, careful physical examination, clear imaging data, superb surgical skills and careful operation are required. 9. Selection of surgical treatment methods: various interventional treatments, various minimally invasive surgeries, various open surgeries. (1) Interventional treatment (ozone, condensation vaporization, PLDD, etc.): cases where imaging is not serious. (2) Minimally invasive surgery (endoscopic surgery, various small incision surgeries): severe disc herniation. (3) Various open surgeries (PLIF): cases with combined intervertebral space stenosis, lumbar instability, spinal stenosis, degenerative scoliosis combined with back and leg pain. Choice of interventional treatment method: For young patients, the use of ozone in large quantities is not recommended. The reason for this is that the use of ozone results in destruction of the intervertebral space and narrowing of the spinal space. Minimally invasive approach: microscopic or endoscopic surgery is preferable, unless combined with pathological changes such as lumbar instability, slippage, degenerative scoliosis, or spinal stenosis, immediate results can be seen, no matter how severe the herniated disc is. The tight blood supply in hospitals in recent years has accentuated the advantages of minimally invasive surgery, as most minimally invasive procedures do not require blood transfusion.