1, the problem of rebound pain: disc removal is a surgical method to take out the disc tissue that originally compressed the nerve. The disc surgery is the same as the changes after double eyelid surgery. First, there will be bleeding and edema around the eyelids, bruising and yellowing, and finally the edema will completely subside. The bleeding is then completely absorbed, presenting a beautiful pair of double eyelids. A void is artificially created around the nerve root after herniated disc removal, but this void is only maintained for a short time. After the surgeon closes the wound, this space is filled with a clot and edema from the surrounding tissue damage. The clot is then mechanically absorbed, the edema caused by the trauma gradually subsides, the injury gradually decreases and the body recovers. During the recovery process, a significant exacerbation of symptoms may occur in different individuals. The time of aggravation starts from 3-5 days to 4-6 weeks or even 3 months for gradual recovery. 2, the problem of incomplete symptom relief: there are many cases of herniated discs. It is common that the discs have been herniated for many years, and finally the pain is too much to bear and come over to the doctor for surgical treatment. See Why do some patients have numbness after surgery? –Also on the timing of surgery for spinal disorders http:///zhuanjiaguandian/likaihua_1576853131.htm, another thing to tell you is that if a piece of disc tissue is protruding on the basis of the level of the posterior edge of the vertebral body compressing the nerve, minimally invasive treatment is is better. If the history of disease is long, the posterior edge of the vertebral body bulge and protrude a disc tissue compression of the nerve, minimally invasive PELD surgery can remove the protruding disc, but can not repair the posterior edge of the vertebral body protruding slope-like bulge, the effect of treatment is poor. Such patients after minimally invasive treatment, patients often feel incomplete symptom relief, the reason is here. 3, the problem of recurrent symptoms: after surgery, most patients can get obvious relief from leg pain. However, there are still some patients who feel back pain, even worse than before surgery. How can this happen? One of the two reasons is that the herniated disc is operated from the lumbar region, if there are no lumbar symptoms, it is normal to have lumbar sleepiness, swelling and even pain after surgery. It is understandable if the symptoms of the lower back were already there, and the symptoms worsen, do not change, or decrease after surgery. The second pathological manifestation of disc herniation is the rupture of the intervertebral disc annulus fibrosus, and part of the disc leaves its original position and compresses the nerve root, resulting in clinical symptoms. The surgical procedure is to take out the ruptured annulus fibrosus that is compressing the nerve, so the pre- and post-operative annulus fibrosus is incomplete. The ruptured and postoperative disc is like a basketball with a rupture and loses its original elastic function. The lumbar motor unit at this point still has motion, but it is an abnormal state of motion. With increasing age, some patients gradually experience narrowing of the intervertebral space, smaller nerve root foramina, small joint hyperplasia, hypertrophy of the ligamentum flavum, calcification of the posterior edge of the vertebral body, and other pathological changes, and patients develop chronic low back pain or gradually develop clinical symptoms of spinal stenosis. These are understandable and normal degenerative processes, and even without surgical treatment, these pathological changes are still inevitable. 4. The problem of recurrence: The problem of recurrence is similar to the problem of recurrent symptoms. The continued degeneration of the remaining discs after disc removal results in three types of manifestations: the first is the degeneration of the discs which manifests as atrophy, air signs within the discs and other degenerative changes. Such patients, often manifesting as low back pain, are very common in clinical practice. The second type is that the disc atrophy is not obvious and continues to move, that is, protrude, such patients show leg pain is often said to relapse, the latter is less common than the former. The third type of manifestation is the mixed type. Patients with low back pain can be treated by various methods such as intervention and fusion. Leg pain can also be treated by interventional, endoscopic, and fusion methods. Other treatment methods postoperatively, in many cases, can be remedied using the PELD method. For example: recurrence after lumbar internal fixation, recurrence after small open surgery, recurrence after MED, recurrence after various interventions, etc., many cases can be remedied using the PELD method. Recurrence after disc herniation remains a benign disease, not comparable to lung cancer recurrence. Some patients because of the fear of recurrence, and refuse or give up the first treatment, in fact, is not the first treatment, he has no chance of recurrence. With the advancement of technology, the return rate is getting lower and lower. Summarizing more than ten years of open revision rate is only 2%. Adding the cases of endoscopic revision; adding the cases with poor outcomes but not undergoing surgery, it is not more than 5%. Therefore, in the long term, the excellent rate of endoscopy is expected to reach 95%. In the treatment of spinal disorders, this is a relatively high rate. The above is a summary of the various problems that can occur with surgery. Even though there are many postoperative problems, the excellent rate of minimally invasive surgery can reach 90% in the long term, and it can reach even higher for skilled surgeons. Although fusion surgery has many advantages, it is highly invasive, expensive, and has many postoperative problems (discussed separately). Starting from the principle of step therapy, I still advocate that most patients under 30 years of age can undergo minimally invasive surgery. Patients of other ages who can undergo minimally invasive surgery should try to give themselves an extra chance.