Traditional surgery requires stripping the paravertebral muscles on both sides, which often leaves muscle atrophy, tissue adhesions, and stiffness, pulling, hidden pain, and heaviness when extending and flexing the lumbar region, partially affecting postoperative satisfaction. The transmuscular access surgery, which enters through the gap of the muscle without stripping and damaging the muscle, has a mild postoperative reaction and does not have the soft tissue sequelae of the lumbar region of traditional surgery. Moreover, the surgery is performed only on the symptomatic side, hitting the lesion directly without revealing the middle, preserving the supraspinous and interspinous ligaments and the contralateral vertebral plate and articular eminence joint, reducing the strain on the nerve root and dura, avoiding nerve injury or cerebrospinal fluid leakage, etc. It is suitable for unilateral symptom-oriented lumbar disc herniation (especially the extreme lateral type), spinal stenosis, and resection of nerve root sheath tumors in combination with intervertebral instability. For patients with lumbar spine fractures, they can also be repositioned and fixed under one incision with access through both sides of the muscle space.