The “perineural decompression and release” is developed from the second-generation lumbar foraminoscopic Thessys technique (Thomas Hoogland endoscopicsystem), also known as the Maxmore technique, and incorporates the wisdom of many domestic experts, including Professor Bai Yibing, to continuously summarize and develop the technique, The Maxmore technique was developed by the wisdom of many domestic experts such as Professor Bai Yibing. Today, “perineural decompression and release” has evolved from a simple minimally invasive spinal technique to an important academic school with a relatively well-developed theoretical system in the field of lumbar interbody foraminoscopy. As early as 2011-2012, many experts in China, led by Prof. Yibing Bai, started to explore how far the minimally invasive lumbar foraminoscopy should go to end the procedure and how the nerve roots should be exposed, based on a generation of Thessys technique. At the beginning of 2012, the German Maxmorespine intervertebral foraminoscopic surgery system entered the Chinese market. This is a new surgical system that replaces the “ring saw”, the representative tool of the Thessys technology, with a “spiral bone drill”. The improvement of the surgical instrumentation has brought about a radical change in the concept of minimally invasive lumbar disc surgery, especially the application of the “spiral bone drill” has greatly improved the safety of the surgical instrumentation, making the position of the reaming tool break through the “safety line” theory and allowing the “spiral bone drill” to be used directly on the lumbar disc. The “spiral bone drill” can be inserted into the spinal canal directly over the “inner edge of the pedicle on the orthoptic radiograph” and operated directly in the anterior space of the dural sac, instead of entering the intervertebral disc, without damaging the nerve tissue in the spinal canal, so that the nerve can be clearly revealed in every operation. The nerve roots can be clearly exposed in every case. Whether the decompression of the nerve roots and dural sac is complete or not directly determines the surgical result, however, the viewpoint of the lateral posterior mirror is different from that of the traditional posterior lumbar open surgery, how can we judge whether the decompression is complete under the mirror? After numerous clinical applications, case analysis and summaries, the criteria for the end of the operation are summarized in the following 6 articles, and the operation is called “nerve root decompression”. ① Space: space around the nerve root; ② Collapse: natural sinking of the nerve root and dural sac; ③ Pulsation: pulsation of the dural sac and the nerve root (pulsation of the dural sac conducted by the nerve root); ④ Blood flow: blood flow on the nerve root; ⑤ Sliding: sliding of the nerve root during straight leg raising; ⑥ Disappearance of subjective symptoms. In November 2013, the National Orthopaedic COA Annual Meeting was opened in Beijing. In the minimally invasive spine session, the topic of the presentation was “Nerve root release for lumbar spinal stenosis”, and the state of the nerve root and dural sac at the end of the procedure was promoted nationwide, which is truly a national promotion. (Although it was first proposed by Prof. Yibing Bai, the announcement was delayed due to various considerations). At that time, there was a sentence that shook the whole audience, “Intervertebral foraminoscopy can treat lumbar disc herniation, central canal stenosis, lateral saphenous fossa stenosis, and vertebral body posterior margin bone redundancy, and as long as there are radicular symptoms and the nerve roots are accurately localized, and extra-vertebral canal diseases are excluded, intervertebral foraminoscopy can be done.” In other words: (1) intervertebral foraminoscopy can be performed as a “relatively contraindication-free” procedure (the indications are very broad but not contraindicated); (2) intervertebral foraminoscopy can be performed as an “exploratory procedure” (regardless of the MRI performance, as long as it is determined that the intradural disease causes radicular (3) the future intervertebral foraminoscopy can be made similar to arthroscopy and become the “gold standard” for the diagnosis and treatment of intravertebral disease, but this is of course a vision. One can only imagine the shock to the traditional spine community once this concept was introduced. Therefore, it is understandable that the concept was widely questioned. It is also understandable why Professor Bai Yibing has been slow to release the end-of-surgery criteria to the public. But the development of the discipline is not subject to human will. In March 2014, at an academic meeting, we shared with our colleagues in the spine field the cases of indications for lumbar foraminoscopy and showed cases of free nucleus pulposus, central canal calcification, lateral saphenous stenosis, lumbar stable slippage, and slippage of the lumbar spine within 1 degree using lumbar foraminoscopy. The number of cases requiring “release” was small, and most cases required “decompression” of the nerve roots. The concept of “perineural decompression and release” was finally confirmed at the symposium. The six criteria for the end of the procedure were changed to “5 criteria for determining whether the decompression is complete microscopically” (hereinafter referred to as “criteria”): Criterion 1: The space around the nerve root – walking Standard 2: Blood flow of the nerve root Standard 3: Pulsation of the dural sac and nerve root Standard 4: Sliding of the nerve root during straight leg raising Standard 5: Disappearance of the patient’s subjective symptoms Afterwards, further standardization of the surgical procedure, operation procedures and standardization of the surgical procedure were put on the agenda. By analyzing the “pressure-causing factors” around the nerve roots, we standardized the surgical names of the “targets for surgical treatment”. The nucleus pulposus, ligamentum flavum, posterior longitudinal ligament, annulus fibrosus, superfluous bone, lateral saphenous fossa, and intervertebral foramen were the targets of surgical treatment, which led to the terms nucleus pulposus removal, ligamentum flavum plication, posterior longitudinal ligament plication/excision, fibrous annuloplasty, superfluous bone excision, lateral saphenous fossa decompression plication, and foraminoplasty. Before the above-mentioned surgical procedures were proposed, there was also a common term: “walking root exploration” and “exit root exploration”, and the seven procedures of “perineural decompression and release” include exit root and The seven procedures of “perineural decompression and release” include all the factors that need to be dealt with for the exit and travel root exploration. The positioning of the puncture and the placement of the sleeve are highly skilled. The placement of the sleeve requires that the tip of the sleeve reach the posterior border of the vertebral body in the lateral view and the spinous process in the orthogonal view (i.e., the midline), and the procedure is mostly complete. The puncture point is set at the “tip of the superior articular eminence” and the angle between the puncture needle and the horizontal plane is adjusted to “30°-50°”, allowing for less disruption of the articular eminence and better enlargement of the intervertebral foramen. This is different from the principle of “the puncture point should be lower rather than higher, and the distance of paracentesis should be shorter rather than longer” proposed by our school in the early days. At this point, “perineural decompression and release” has formed an academic school with a relatively complete theoretical system. In August 2014, at the first meeting and inaugural meeting of the Spinal Endoscopy Group of the Minimally Invasive Spine Committee of the Chinese Society of Integrative Medicine in Xi’an, the “perineural decompression and release” was officially announced and promoted. (Prof. Yibing Bai summarized the characteristics of this school of thought as “a surgical procedure that is broad in its indications, relatively easy to master, immediate in its effects, and close to the lesion”, so some people in the field took the initials of its characteristics to form the BEIS technique.