Lumbar disc herniation is a common degenerative disease of the lumbar spine with low back and leg pain as the main symptom,. Since 1934 when Dr. Mixter, a neurosurgeon at Harvard University, and Dr. Barr, an orthopedic surgeon, applied nucleus pulposus removal for the treatment of lumbar disc herniation, the history of surgical treatment of lumbar disc herniation has been more than 80 years. Nucleus pulposus removal has become the classic procedure for the treatment of lumbar disc herniation. Due to the lack of awareness of postoperative complications and the excessive pursuit of economic benefits, lumbar fusion has been abused, raising questions among experts. And the application of lumbar non-fusion has also seen expansion due to the advanced concept, easy operation, preservation of crural segmental motor function and maintenance of lumbar spine stability. 1, the classic nucleus pulposus removal surgery efficacy is accurate, is still the mainstream method of surgical treatment of lumbar disc herniation, do not have to routinely lumbar spine fusion. Nucleus pulposus removal for lumbar disc herniation is effective and should still be the mainstay of surgical treatment for lumbar disc herniation. Over time, the efficacy of Nucleus pulposus removal surgery has been declining, and postoperative complications of spinal stenosis and lumbar instability are believed to be the main reasons for the decline in efficacy. In fact, the incidence of lumbar instability or spinal stenosis after nucleus pulposus removal is not high. There is not enough evidence that lumbar fusion is routinely required when patients with lumbar disc herniation receive their first surgical treatment. Due to the lack of understanding of the reasons for the decline in long-term efficacy after nucleus pulposus removal, coupled with the excessive pursuit of economic benefits by some clinicians, there is a tendency for the surgical treatment of lumbar disc herniation to be enlarged, and lumbar fusion has been misused in the surgical treatment of lumbar disc herniation. However, the loss of motion function of the crural segments after fusion and the degeneration of the neighboring segments caused by excessive stress concentration have attracted attention and become the focus of scholars’ attention. Therefore, for patients with simple lumbar disc herniation, it is not necessary to routinely perform lumbar spine fusion, and lumbar spine fusion should be used in the surgical treatment of lumbar disc herniation in a prudent manner. 2, lumbar fusion in lumbar disc herniation surgery should strictly grasp the indications for surgery. The purpose of lumbar fusion in the surgical treatment of lumbar disc herniation is to avoid the re-projection of the disc and maintain the stability of the lumbar spine. At present, the indications for lumbar fusion in lumbar disc herniation surgery are still controversial, and most experts believe that lumbar fusion should be performed in the following cases: (1) high lumbar disc herniation, such as T12 L1 herniation or L1 ~ 2 herniation. Lumbar fusion can avoid disc herniation in neighboring segments after disc removal. (2) Total laminectomy and synovectomy during nucleus pulposus removal. Lumbar fusion can maintain the stability of the lumbar spine and avoid postoperative lumbar instability or lumbar spine slippage and disc reherniation. (3) Combined lumbar spinal stenosis. The structure of the posterior column of the vertebral column is damaged during surgery, and lumbar fusion is necessary to maintain the stability of the vertebral column. (4) Combined with lumbar segmental instability. (5) Combined lumbosacral vertebral developmental deformity. Due to the stress changes in the lower lumbar spine caused by the crural deformity, lumbar fusion can be performed after nucleus pulposus removal to avoid re-projection of the disc in the original segment or herniation of the disc in the neighboring segments. (6) Reoperation for lumbar disc herniation. Lumbar spinal fusion is necessary because reoperation will cause greater damage to the lumbar posterior column structure and affect the stability of the vertebral column. (7) Giant lumbar disc herniation or combined giant endplate rupture. (8) Combined with cauda equina syndrome. 3, lumbar non-fusion has certain advantages, but there are some problems, should strictly grasp the indications. In order to solve the problems of lumbar spine fusion, retain the motion function of the crural segments, and maintain the stability of the lumbar spine, lumbar spine non-fusion technology began to be used in the clinic. Compared with lumbar fusion, lumbar non-fusion technology has theoretical advantages in the treatment of lumbar degenerative diseases: (1) It does not require bone grafting, avoids the preparation of bone grafting beds and complications in the bone donor area, reduces surgical trauma, and shortens the postoperative recovery time; (2) non-fusion technology preserves the mobility of the operated segments to a certain extent, avoids the stress concentration on the neighboring segments due to fixation, and slows down degeneration of the neighboring (3) While preserving the motion function of the operated segment, the non-fusion endoprosthesis can reduce the load on the intervertebral disc and small joints, and slow down the degeneration of the entire crural motor unit. Therefore, in lumbar disc herniation surgery, the application of lumbar non-fusion technology should strictly grasp the indications, and should never blindly expand the scope of application and increase the economic burden of patients. 4. Minimally invasive technology has brought revolutionary changes to the surgical treatment of lumbar disc herniation. In recent years, with the emergence of the “3rd generation of crest endoscopy”—intervertebral foraminoscopy technology and various minimally invasive fusion technologies, the crest minimally invasive technology has developed rapidly, and the surgical treatment of lumbar disc herniation has undergone revolutionary changes, and there has been no change to the surgical treatment of lumbar fusion and fusion. The surgical treatment of lumbar disc herniation has been revolutionized by the rapid development of crestal minimally invasive technology, which has also had a profound impact on the development and application of lumbar fusion and non-fusion surgery. The application of crestal minimally invasive technology, on the one hand, avoids the destruction of crestal stability by open surgery, further improves and expands the concept and scope of lumbar non-fusion surgery, and reduces the application of lumbar fusion surgery. For example, with the application of intervertebral foraminoscopic technique, the surgery can be accomplished with preservation of the articular eminence without the need for further fusion. Nucleus pulposus removal is the classic procedure for the treatment of lumbar disc herniation, which has a definite efficacy and should remain the mainstream method of surgical treatment of lumbar disc herniation. The purpose of lumbar fusion is to avoid reherniation of the intervertebral disc and to maintain the stability of the lumbar spine. For patients with simple lumbar disc herniation, lumbar fusion is not required routinely. Lumbar fusion in lumbar disc herniation surgery should strictly grasp the indications for surgery. Compared with lumbar fusion, non-fusion technology has certain advantages in the surgical treatment of lumbar disc herniation, but the indications should be strictly grasped and carefully selected to avoid blindly expanding the scope of application of the surgery and causing abuse. The development of minimally invasive technology has led to profound changes in the traditional surgical treatment of lumbar disc herniation, and the concept and scope of lumbar non-fusion has been further improved and expanded; whereas the application of lumbar fusion has gradually decreased, and has been further minimally invasive, limited, precise and diversified.