The development of lumbar spine surgery in recent years has shown several trends, namely, minimally invasive, small incisions, strong intraoperative fixation, and reliable bone grafting. There are several concepts that need to be clarified. Small incisions are not necessarily minimally invasive (e.g., discoscopic surgery has a small incision, but there is no significant difference between the effect on spinal stability and open surgery), strong intraoperative fixation is not equal to reliable spinal stability after surgery (near-term stability relies on internal fixation, and long-term stability relies on implantation), and satisfactory internal fixation does not mean that there is a satisfactory postoperative outcome (decompression and protection of lumbar back muscles are also factors affecting the outcome of surgery), in addition, the development of spinal surgical instrumentation has been a key factor in the development of spine surgery. (Decompression effect and protection of the low back muscles are also factors affecting surgical results), in addition, the development and use of spinal surgical instruments, obviously increased the cost of surgery (such as discoscopy, channel system, intervertebral foramenoscopy), but also did promote the development of spinal surgery. 1, paravertebral interspace approach: In recent years the development of spinal surgery in addition to advances in instrumentation, is the improvement of surgical access. The traditional posterior approach requires stripping the multifidus muscle from the spinous process and pulling it for a long time, which results in scarring and weakness of the muscle after the operation, decreasing the static maintenance of the spine, and causing low back pain and instability. The paravertebral interspace approach enters through the gap between the multifidus muscle and the longest muscle to directly expose the pedicle root, avoiding the stripping of the multifidus muscle (Fig. 1), and the trauma is significantly reduced. It is suitable for patients who do not need total laminar decompression. 2.TLIF transforaminal lumbar interbody fusion TLIF is a surgical technique, but also a concept.TLIF is a unilateral transforaminal approach (Fig. 2), the implant is placed into the intervertebral space through the approach, which preserves the posterior structures such as the vertebral plate of the contralateral side and protects the tension band, thus making circumferential fusion possible; since the approach is unilateral, the decompression is unilateral, and is in the region of the foramen ovale, therefore, the impact on the intracanalar spine can be minimized. Since the approach is unilateral, decompression is also unilateral and in the region of the intervertebral foramina, it can minimize the disturbance to the spinal canal, maintain the intravertebral environment and reduce the corresponding complications, which is in line with today’s minimally invasive surgical trend, and it is mainly applicable to lower lumbar spine disorders requiring unilateral decompression and intervertebral body fusion. 3. Intervertebral foraminoscopy: Intervertebral foraminoscopy is only applicable to patients with herniated discs, and cannot be used for internal fixation, and is not suitable for patients with spinal stenosis and spondylolisthesis. Intervertebral foramenoscopy technology is the application of medical endoscopy in the patient under local anesthesia, conscious situation, through small tissue trauma, side way through the intervertebral foramen safety triangle using annular perforation grinding small articular protrusion, break through the annulus fibrosus into the intervertebral disk to establish a nucleus pulposus extraction work channel, and then the use of small nucleus pulposus clamp and bipolar radiofrequency bending electrodes in the visualization of the disc and the protrusion of nucleus pulposus extraction and ablation (lumbar 5 sacral) The central type of herniation of lumbar 5-sacral 1 has to be extracted and ablated (the nucleus pulposus has to be extracted by biting off the vertebral plate and ligamentum flavum through the intervertebral plate space through the posterior approach), so as to achieve the purpose of treating herniated discs (Fig. 3), and the emergence of this technology has made the substantial treatment of herniated discs enter into the era of minimally invasive.