[Objective] To compare visual and fluoroscopic of articular process forming treatment respectively with Lumbar disc herniation with lateral recess stenosis. [Methods] A retrospective analysis of 2018-01 to 2019-06 in our line of 46 cases of PTED surgery patients, 23 cases of visual group, spinal canal decompression after visible articular process forming, the other 23 cases for perspective group, spinal canal decompression after fluoroscopic articular process forming.[Results] The average follow-up time was 17(9-24) months.There were no statistically significant differences in VAS back pain score, VAS leg pain score, JOA and ODI score between the two groups within 1 month after surgery （P>0.05）.The VAS leg pain score, JOA and ODI scores of the visual group were better than those of the fluoroscopy group at 3 months and the last follow-up, and the difference was statistically significant（P＜0.05）.The operation time of the visual group was (51.3±7.3) min, which was shorter than that of the fluoroscopic group (71.8±9.3) min.The number of fluoroscopy in the visual group was (5.3±1.0) times, which was lower than that in the visual group (16.9±1.8) times.The differences were statistically significant (P < 0.05).[Conclusion] Visual arthroplasty has the advantages of good medium and long term effect, less fluoroscopy times and shorter operation time.