The surgical principles of minimally invasive techniques include small skin incisions, minimal soft tissue interference, image guidance, and the application of special surgical hooks and instruments. The fundamental aim is to obtain equivalent efficacy to open surgery while reducing surgical trauma and facilitating patient recovery. A recent article in Spine by Mark M-Mikhael et al. describes a minimally invasive technique for posterior cervical spine fixation with foraminotomy and decompression of the lateral block screws. A posterior median incision is made, the muscle is split through a paramedian approach, and a tubular expandable retractor is used to expose the synovial joint and lateral block to complete multisegmental foraminal decompression and lateral block screw fixation. The tubular retractor can significantly reduce medically induced muscle injury and avoid ischemic muscle injury caused by common pulling hooks in open surgery, and the patient has less postoperative pain and faster recovery. The authors concluded that this technique can achieve similar efficacy to anterior discectomy implant fusion internal fixation (ACDF) and can be used as an alternative procedure to ACDF, although there are complications such as incomplete decompression, poor placement of the built-in object, nerve injury, and painful postoperative muscle spasm due to inadequate exposure. The indications, contraindications and technical points are as follows: 1. Indications for surgery: first or revision surgery for single or multiple segments; patients with radicular symptoms due to stenosis of the intervertebral foramen caused by bony or soft disc herniation; patients with stubborn radicular pain after failed anterior surgery. 2. Indications for lateral block screw fixation and fusion surgery: cervical instability; patients who have undergone anterior bone graft fusion or posterior laminectomy. 3, contraindications to surgery: anterior median compression caused by spinal cord type cervical spondylosis; lateral block fracture, dysplasia or absence, vertebral artery travel abnormalities and other circumstances, can not be performed lateral block screw fixation. 4. Technical points: 1) Incision and retractor installation: A longitudinal posterior median cervical incision, about 3-4 cm long, with a single-segment decompression incision centered on the diseased segment and a multi-segment decompression incision centered on the last segment of the last segment of the operation. The deep fascial incision is made bilaterally with the same length as the skin incision and is deviated from the midline by 4-6 mm. The operator separates the muscle gap bluntly with the fingers to reach the articular eminence and the lateral block, installs a gradual expansion cannula, and the tubular retractor is placed and fixed with a universal fixation bracket with adjustable orientation and angle, and can be introduced into the light source. The procedure is performed under image surveillance to ensure accurate retractor position (Figure 1). In cases of multisegmental decompression, the tubular retractor should be positioned one segment above the most caudal segment to increase the extent of exposure through retractor expansion (Figure 2). 2) Foraminotomy: Fully expose the articular eminence and the inner and outer edges of the lateral block, and expose the adjacent segments by adjusting the angle of the retractor (Figure 3). The medial half of the inferior articular eminence is removed with a 2 mm high-speed grinding drill, and part of the lamina is excised to reveal the ligamentum flavum. The ligamentum flavum is excised with a 1 mm gun-type biting forceps to reveal the supra-articular eminence and the foraminal bone. If the nerve root foramen is severely narrowed, the nerve root foramen can be decompressed with a scraping spoon to avoid the occupying effect of the gun bite forceps leading to medically induced nerve root injury. The nerve root is gently pulled upward with a fine nerve root pulling hook to protect it, and then the soft disc can be removed, taking care not to treat the anterior cervical nerve root as an intervertebral disc. 3) Lateral block screw fixation technique: align the target segment and adjust the retractor so that it is in the direction of 15° head tilt, select the lateral block center point 1mm inward as the nail entry point, first penetrate the cortex with a 2mm grinding drill, maintain 15° head tilt (parallel to the articular surface of the synapse), 30° outward tilt, punch a hole with a 2.5mm drill bit, limit the depth to 14mm, drill through the contralateral cortex, measure the depth, tap, and screw in a 3.5mm universal screw . Reorient the pulling hook and repeat the above operation to complete the multisegmental screw placement. Intraoperatively, fluoroscopy can be used to further confirm the correct screw position. Adjust the spreader tabs of the spreader to provide sufficient space for placement of the connecting rod and tail cap.