Achieving good treatment results with minimal surgical trauma has always been the goal of spine surgeons. With the advancement of clinical medical technology and the improvement of medical equipment, minimally invasive spine surgery techniques have been widely developed in China. However, some controversies have emerged during the rapid development of minimally invasive spine surgery technology, such as the understanding of the meaning of minimally invasive spine surgery; the individualization of minimally invasive surgical techniques; what minimally invasive techniques are optimal for a particular spinal disease; and whether minimally invasive techniques can replace traditional open surgery, etc. It is necessary to reacquaint ourselves with these issues. Minimally invasive incisions do not mean minimally invasive; on the contrary, minimally invasive surgery can become massively invasive if the indications for surgery are not properly chosen, so the choice of indications is the key to the success or failure of this operation and its efficacy. Therefore, the selection of indications is the key to the success of this operation and its efficacy. If the indications for a certain minimally invasive technique are expanded arbitrarily, the consequence is that effective treatment is not achieved and other serious complications may arise. Minimally invasive surgery needs to be individualized. For elderly and frail patients, minimally invasive surgery is a good choice, but these patients have no obvious cosmetic requirements, so the size of the incision should not be pursued too much, and more consideration should be given to shortening the operation time and less disturbing the stability of the internal environment of the body. For women, especially young women, the cosmetic needs are particularly high, so more consideration should be given to the size of the incision. It is hoped that we can perform spinal surgery through tiny incisions along the skin lines and achieve no or minimal scars after surgery, so that the patient will always be youthful and beautiful. Each minimally invasive procedure has advantages and disadvantages and is not a substitute for traditional surgery. The advantages of discoscopic surgery for lumbar disc herniation are obvious, but it has not been widely adopted because of the difficulty of mastering the technique well, and because its indications have been expanded and more complications have arisen. Does the less invasive intervertebral foramen technique replace other minimally invasive procedures or traditional open surgery? The answer is no. It has relatively narrow indications and, in addition, for patients with lumbar disc herniation with spinal stenosis, foraminoscopy is out of its depth, whereas discoscopic surgery can achieve satisfactory results. Therefore, there is a range of spinal disorders treated by each minimally invasive spinal surgery technique.