With the development of spondylosis research and advances in imaging, especially the popularization of MRI, the diagnosis of spondylosis in clinical practice is becoming clearer and clearer, and at the same time there is more and more confusion and controversy. Especially the diagnosis of intervertebral disc herniation. Now we refer to the relevant literature to make a brief overview. 1, the concept of thoracolumbar intervertebral disc herniation thoracolumbar segment, including the lower thoracic T11, T12 and upper lumbar L1, L2 segments, is the conversion of thoracic vertebrae to lumbar vertebrae anterior convex, but also easy to injure the site. The neural structures in the thoracolumbar spinal canal include the upper lumbar conus medullaris, the conus, the cauda equina and the nerve roots. 90% of the people’s spinal cord terminates at the L1 vertebral body or L1/L2 interspace plane, while some people’s spinal cord terminates at the lower 1/3 of the T12 vertebral body to the middle 1/3 of the L3. 2.Clinical manifestations and diagnosis The early symptoms of this disease are atypical, manifested as lumbar back pain and discomfort, often misdiagnosed as lumbar back fascia, muscle chronic strain, etc. When the spinal cord compression symptoms are obvious in the late stage, it is often easy to be confused with intradural tumors, cervical intervertebral disc protrusion, lumbar intervertebral disc herniation and so on. Thoracolumbar disc herniation mainly causes back pain, lower limb pain, walking dysfunction and sphincter dysfunction. t11/12 disc herniation mainly causes upper motor neuron damage, manifested as back pain, lower limb pain, pain is often difficult to localize, walking obstacle is obvious due to pain, tendon reflexes are hyperactive, and the cone beam sign is positive; t12/l1 disc herniation can cause damage to the lower motor neuron, and it can cause damage to the upper motor neuron, and it can also cause damage to the upper motor neuron, and it can also cause damage to the upper motor neuron. T12/L1 disc herniation can cause damage to lower motor neurons and also upper motor neurons, and there can also be nerve root compression. Manifestations include radicular pain in the anterior and lateral thighs, impaired walking, and sphincter dysfunction. Tendon reflexes can be hyper or hyperexcitable, pyramidal signs can be positive or normal, and there can be a positive femoral nerve pull test.L1/2 disc herniation is mainly characterized by nerve root compression, with obvious radicular pain in the anterior and lateral thighs, tendon reflexes are basically normal, and generally there are no pyramidal signs, and the femoral nerve pull test is mostly positive. These clinical manifestations are basically consistent with the neuroanatomy of the thoracolumbar segment, indicating that the clinical manifestations of thoracolumbar segment disc herniation have a certain regularity, but due to anatomical variation and different types of herniation, the clinical manifestations of the same disc herniation are also different, which results in the uncharacteristic clinical manifestations. Some scholars believe that the following conditions suggest the possible existence of thoracolumbar disc herniation: ① thoracic back, anterior thigh or groin pain ② lower extremity pain is widespread and vague, difficult to localize ③ gait disturbance, but lumbar spine examination is difficult to explain ④ hyperreflexia of the knee and/or ankle clonus, even if mild abnormalities need to pay attention to ⑤ obvious lumbosacral radiculopathy manifestations, but the lumbosacral imaging is difficult to interpret the clinical manifestations. Most thoracolumbar disc herniations start slowly, have a long history, and gradually worsen. The most prominent clinical symptoms are weakness and numbness of the lower limbs, some patients show stiffness and inflexibility of the lower limbs, often complaining of numbness of the whole lower limbs. In addition, pain and difficulty in urination and defecation are also more common. Very few patients even exhibit signs and symptoms of nerve root damage from lumbar disc herniation. Since the nerves that may be involved are the spinal cord lumbar bulge, spinal cord cones or cauda equina, this makes the presentation of thoracolumbar disc herniation complex and varied. When the disc herniation is located in the T10~11 segment, the clinical manifestation is mainly upper motor neuron damage, i.e., physiological reflexes of the lower limbs are hyperactive, pathological reflexes are positive, and muscle tone is increased, etc.; when the disc herniation is located in the T11~12 or T12~L1 segment, the manifestation of damage to the upper motor neuron and the lower motor neuron can occur at the same time, i.e., there may be a decrease in physiological reflexes or a pathological reflexes of the lower limbs may be induced. When the disc herniation is located in the L1~2 segment, it is mainly manifested as damage to the cauda equina. It is worth noting that these symptoms and signs are not unique to thoracolumbar disc herniation, and clinically compressive disorders of the thoracolumbar segment can have the above manifestations, such as thoracolumbar OPLL and posterior convex deformity. Understanding this feature, through careful physical examination, will help us to determine the lesion site more accurately. Some scholars suggest that if X-ray radiographs show that the patient’s thoracolumbar spine has increased posterior convexity, or one or two vertebrae have wedge-shaped changes; or the posterior margin of the vertebral body is found to be highly suspected of thoracolumbar herniated discs, and the diagnosis can be confirmed by further MRI examination. 3.Conclusion It is necessary to put forward in particular. The MRI examination shows that up to 15% of the cases of thoracic disc herniation do not have neurological signs and symptoms, so the diagnosis can only be confirmed by combining the clinical symptoms with comprehensive consideration.