Lumbar and leg pain is one of the most common clinical symptoms, and according to statistics, more than 90% of people have experienced different degrees of lumbar and leg pain in their lifetime. Lumbar disc herniation is a common cause of low back pain, especially for those who have been engaged in long-term stooping work, such as drivers, teachers, welders, renovation masters and civil servants, etc., because the lumbar vertebrae in the stooping forward bending to withstand a greater load of pressure, the disc is more likely to tear and herniate. With the changes of modern work and life style, people have more and more chances to bend over, the incidence of lumbar disc herniation is also higher and higher, and shows the trend of youthfulness, generalization and complexity. 80% of the patients with lumbar disc herniation can be treated by conservative measures, and only those patients who are ineffective in conservative treatments or recurrence need surgical treatments. It should be said that the current surgical methods, whether it is simple nucleus pulposus removal or spinal canal decompression surgery, have been practiced for many years with satisfactory efficacy and few complications. However, these surgeries require general anesthesia and bed rest for at least 4 to 6 weeks after surgery, which may delay the work of young patients, and make the surgery risky for the elderly due to the deterioration of heart, lung, liver and kidney functions. Minimally invasive surgery has the advantages of less trauma and faster recovery, and has become the development direction of modern surgery, which also includes in the treatment of lumbar disc herniation. At present, in the treatment of lumbar disc herniation, “minimally invasive” is reflected in three levels: 1. Nerve root block: It is also called “closure” in daily life, and its principle is to reduce the patient’s pain symptoms by blocking the conduction of pain. This is a simple treatment, through local anesthesia in the nerve around the injection of drugs, trauma, risk is small. Theoretically, this way can not completely cure lumbar disc herniation, mainly applicable to: (1) acute stage of disc herniation, severe pain, affecting work and rest; (2) elderly patients combined with heart, lungs, kidneys and other serious diseases, the risk of surgery is high; (3) closure combined with bed rest, nerve dehydration and other treatments, some of the patient’s symptoms can be controlled for a long time; (4) for certain intractable low back pain but the diagnosis of the patient is not clear. Nerve root block can be performed for diagnostic treatment. If the symptoms are relieved after closure, it means that the low back pain is related to the nerves. Radiofrequency ablation, ozone injection and other surgeries: the principle of this type of surgery is to inject ozone into the herniated disc, or use radiofrequency to ablate the degenerated disc, which is effective for patients with bulging at the early stage, but unsatisfactory for the treatment of herniated or prolapsed discs in the spinal canal. Now this type of surgery is gradually reduced. 2.Intervertebral foraminoscopy surgery: It is a minimally invasive spinal surgery system composed of specially designed intervertebral foraminoscope and corresponding supporting minimally invasive spinal surgical instruments, imaging and image processing system, etc. The surgery is performed locally under the patient’s consciousness. The surgery is performed under local anesthesia and puncture under the patient’s awake state, and the tiny skin incision is completed, with no interference to the spinal canal, and the protruding degenerated nucleus pulposus tissue is taken out under the intervertebral foramenoscopy, with little trauma, without destroying the paraspinal muscles, ligaments, and affecting the stability of spine, and the spinal canal and nerve roots can be clearly observed through the intervertebral foramenoscopy, and the protruding degenerated nucleus pulposus tissue is taken out under the direct vision of the endoscope. Intervertebral foramenoscopy surgery for lumbar disc herniation is a real minimally invasive surgery, its features include: (1) small surgical risk: the patient is operated under local anesthesia, the patient’s systemic conditions such as heart, lungs, liver and kidneys, etc. requirements are not high, especially for some of the elderly patients who can not tolerate general anesthesia; (2) small surgical trauma: the surgical incision of no more than 1 centimeter, the muscle interference is small, does not damage the bony structure of the spine, is through the normally existing intervertebral foramina; (3) Satisfactory efficacy: published international literature has reported a success rate of over 90% and an early recurrence rate of less than 5% at 1- and 2-year postoperative follow-ups. Even patients with recurrence can be treated with open surgery again if necessary. (4) Fast recovery: patients can go to the floor the same day after surgery, and are discharged from the hospital within 5 to 7 days, and return to normal activities in 3 to 4 weeks. Suitable people for intervertebral foramenoscopy surgery: In principle, patients with lumbar disc herniation with clear radicular symptoms can receive intervertebral foramenoscopy surgery as long as lumbar instability is excluded. (1) Young patients with a short history of disease, clear radicular symptoms, and single-segment herniated discs are the best candidates for intervertebral foramenoscopy; (2) CT or MRI shows multi-segment herniated discs, but the doctor’s clinical examination can identify a major responsible segment, which is also suitable for intervertebral foramenoscopy; this is mostly seen in middle-aged and old-aged patients with a longer history of disease; (3) Herniated discs are accompanied by stenosis, which can be performed by the patient. Intervertebral foramenoscopy can be performed to remove the herniated disc while foraminoplasty is performed. In recent years, the widely recognized posterior discoscopy technique (MED) can be applied to all kinds of lumbar intervertebral disc herniation, but its surgical access and surgical process are the same as the small incision open surgery method, which needs to be carried out through the paraspinal muscle access and vertebral plate window, muscle ligaments and bone structure resection, so its minimally invasiveness is limited, only small incision but not minimally invasive. More than 2/3 of the hospitals in China basically stopped using it after some surgeries were done at the initial stage of purchase. 3, spinal canal decompression and fusion surgery: the emergence of intervertebral foraminoscopy surgery, so that most of the lumbar disc herniation can be treated with local anesthesia and minimally invasive treatment. However, for patients with bony spinal stenosis, lumbar spondylolisthesis and lumbar spine instability, the cause of low back and leg pain is no longer just a soft tissue problem such as a herniated disc, but a bony problem. This condition often requires decompression of the spinal canal and fusion stabilization. Simply put, the spine is like a wall. If the wall is old (herniated disc), we can renovate it (remove the herniated disc); however, if the wall is already crooked or even collapsing (lumbar spine instability), the renovation will be useless, and it must be fixed securely (do fusion surgery). Therefore, for middle-aged and elderly patients with low back pain, the first thing to do is to understand the stability of the spine through radiographs. If it is confirmed that the spine is stable, even if there is a multisegmental herniated disc or mild slippage, it is still possible to take the intervertebral foramenoscopic surgery; however, if it is confirmed that there is lumbar spine instability, it is necessary to carry out lumbar spine fusion after decompression surgery. Compared with traditional open surgery, these surgeries have recently adopted minimally invasive methods to minimize incisions and trauma, such as PLIF or TLIF. Experienced surgeons can minimize the duration of the surgery and the incisions, which reduces the trauma and risk of the surgery, and also achieves the goal of early discharge from the bed (3~5 days after surgery) and early recovery.