1. Do all lumbar disc herniations require surgery? Lumbar disc degeneration is a normal phenomenon in the aging process of people, just like the appearance of wrinkles on the skin. If it does not cause symptoms, no treatment is needed. When lumbar disc herniation occurs, conservative treatment is preferred. Conservative treatment includes bed rest, medication, traction and physical therapy. After strict conservative treatment has no effect and seriously affect the work and life of the situation before you need to consider surgery. 2, lumbar disc herniation surgery choose minimally invasive treatment or fusion treatment? What surgical method is used after the failure of formal conservative treatment? Generally speaking, the structure of the human body is the original good, so the human body needs to choose the treatment method that has the least impact on the original normal structure after the problem occurs. For example, if a cavity can be filled, it should not be extracted to install dentures. So for open fusion treatment and minimally invasive treatment can achieve satisfactory results, the priority is to choose minimally invasive treatment. 3.Will lumbar disc herniation recur after surgery? Patients often ask: Will lumbar disc herniation recur after surgery? Is minimally invasive surgery a “radical” surgery? To answer these questions, it is important to recognize that the lumbar disc is a normal structure of the body and has important functions: cushioning pressure and maintaining lumbar spine mobility. Therefore, if the disc is completely removed, the function of the lumbar spine is partially lost. The problems associated with fusion surgery, which requires complete removal of the disc, are also obvious. It is important to use minimally invasive methods to remove the disease-causing portion of the disc and preserve the rest of the normal disc tissue to relieve symptoms and preserve the function of the lumbar spine. It is like a tooth decay, which is broken first, then broken again, and then extracted only when it is really bad. Although herniation may still occur after minimally invasive treatment of lumbar disc herniation, do not worry because it is not a malignant tumor. Moreover, the reoperation rates of minimally invasive surgery and fusion surgery do not differ much when experienced professionals deal with lumbar disc herniation. 4.What are the minimally invasive surgeries for lumbar disc herniation? Minimally invasive surgery for lumbar disc herniation is currently performed in our hospital: 1) percutaneous endoscopic (foraminoscopic) lumbar disc removal (PELD); 2) microscope-assisted lumbar disc removal under the channel; PELD surgery is performed under the endoscope, and the disease-causing disc is removed by clearly observing the disc and its surrounding tissues through magnified video. Microscope-assisted lumbar disc removal under access is performed with the aid of a special tube, and the disease-causing disc is removed under direct microscopic vision. The former incision is relatively small, less than 1 cm. 5. What are the advantages of percutaneous endoscopic (laminar foraminoscopy) lumbar disc removal (PELD)? PELD is the preferred minimally invasive treatment modality for lumbar disc herniation. When this procedure is difficult due to anatomical abnormalities, microscopically assisted lumbar disc removal under access can be used. The advantages of PELD are obvious: (1) local anesthesia, fast recovery, and intraoperative communication with the patient to prevent nerve damage. (2) small incision, about 7 mm, although the incision is small, but through the endoscope can see the internal tissue structure, just like a gastroscope, the doctor can see the internal structure of the stomach without drilling into the stomach. This surgery does not need to bite the bone, do not cut the yellow ligament, so the damage to normal tissue is very small. (3) Less bleeding, PELD patients do not need blood transfusion treatment. The amount of bleeding is similar to the amount of blood drawn during a physical examination. (4) No antibiotics are needed after surgery. Reduce antibiotic resistance problems, reduce drug side effects. (5) Short hospital stay: you can be off the floor 4 hours after surgery and be discharged the next day. (6) Low cost: lower cost than open fusion surgery because no internal fixation material needs to be implanted. (7) Non-ultimate surgery, retaining lumbar spine motion function. 6.Is radiofrequency ablation surgery a more minimally invasive surgery for lumbar disc herniation? Radiofrequency ablation surgery is an interventional treatment, and this type of treatment also includes ozone, collagenase, laser, etc.. They are not really surgical in the sense that they do not cut the skin and are operated under blind vision through puncture, so they are only suitable for patients with mild disease. 7.What is the reason for the reappearance of symptoms after minimally invasive surgery for lumbar disc herniation? The reappearance of symptoms after the disappearance of early symptoms may be due to the edema reaction of the nerve. Generally speaking, if you take rest and protect the lumbar spine after surgery, the symptoms that appear again can gradually disappear. However, if symptoms appear in the distant future, the cause of the symptoms should be analyzed. If it is sciatica, then you need to check to see if the lumbar disc has protruded again and in which area. If it is just lumbar pain, it may be a degeneration such as lumbar instability, there is no need to worry too much, you can strengthen the lumbar back muscle training by strengthening it, we have a very good rehabilitation team can guide the exercise.