Posterior spinal nerve syndrome is a syndrome characterized by low back pain, posterior lateral hip and thigh pain, lumbar muscle spasm, and movement disorders caused by mechanical stimulation of the posterior branch of the spinal nerve, such as kaya. The mechanism is that when the posterior branch of the spinal nerve and its branch of the medial and lateral branches travel in the bone fiber holes, bone fiber tubes, or through the thoracolumbar fascial fissure and other small, tough and inelastic peripheral structure of the foramen ovale, due to the lumbar mobility, it is easy to be mechanically strained; or due to the osteophytes, ligamentous ossification, so that the foramen ovale deformity narrowing, and compression of the blood vessels and nerves triggered the symptom. [The posterior branch of the spinal nerve has a diameter of about 1mm, and it emanates from the lateral side of the spinal ganglion at the foramen externum of the intervertebral foramen, and travels backward through the fibrous foramen of the vertebrae between the mastoid process and the paraspinal process, and then divides into medial and lateral branches at the upper edge of the lower superior articular eminence and transverse process, and then divides into medial and lateral branches at the inner edge of the transverse intertransverse muscle, and there is anastomosis among the various posterior branches of the spinal nerve.1 The posterior medial branch is located in the posterior aspect of the upper articular eminence of the lumbar vertebrae in the lower position and the back of the transverse process obliquely backward. inferiorly, turning downward through the bony fiber canal to the back of the arch plate, spanning 1~3 vertebrae, and overlapping and distributing to the joint capsule, ligaments, and dorsal extensor muscles on the medial side of the articular connecting line. The medial branch of lumbar 4-5 travels downward across 2 to 3 vertebrae to reach the dorsal surface of the sacrum and also distributes in the sacroiliac joints. The posterior medial branch connects with branches in the upper and lower planes within the lumbar dorsal muscles, abuts the vertebral plate, and continues to the inferior border of the spinous process, where the supraspinous ligament is innervated by the posterior medial branch of the previous plane.2 The posterior lateral branch, accompanied by blood vessels, travels outwardly and downwardly obliquely along the dorsal surface of the transverse processes, passes through the sacral spine muscle, and penetrates the thoracolumbar fascia to the subcutaneous level to innervate the tissues and structures outside the line of the intervertebral joints. The lateral branches of lumbar 1~3 are longer, forming the gluteal ependymal nerve.3 The spinal branches are mostly branches of the posterior branch of the spinal nerve or the trunk of the lumbar nerve, which return to the vertebral canal through the intervertebral foramen (returning nerves), and are distributed in the annulus fibrosus, the posterior longitudinal ligament, the connective tissue of the dura mater, blood vessels, and the periosteum of the spinal cord (spinal branches), which join with the sympathetic fibers to form the sinusoidal spinal nerves. Sinus vertebral nerve has extensive anastomosis between adjacent segments, and thus the stimulus may be transmitted to the center across segments and sides, causing low back pain.4. Osteofibrotic foramen is located in the posterior and posterior aspect of the foramen magnum, with its opening towards the back and perpendicular to the foramen magnum. Its upper border is the sickle edge of the intertransverse ligament, the lower border is the upper edge of the transverse process of the lower vertebra, the inner border is the outer edge of the superior articular eminence of the lower vertebra, and the outer border is the inner edge of the intertransverse ligament.5 The osteofibrous canal is located in the bony groove between the mastoid process and the paracentral process of the lumbar vertebra. The anterior wall is the interosseous groove between the mastoid process and the paracentral process, and the posterior wall is the superior articular process and the paracentral ligament. [Symptoms] Low back pain, hip pain, posterior lateral thigh pain, not exceeding the knee joint. Signs and symptoms]: Complaints of pain in the upper edge of the root of the transverse process of the 1-2 segments above the pain area, accompanied by the complaints of pain to the pain area of the discharge pain. Differential Diagnosis] 1, lumbar disc herniation: leg pain is more disseminated to the calf, and the high level is disseminated to the anterior lateral thigh. CT, MR can be differentiated from 2, osteoporosis: most common in elderly women, spinal column extensive pressure pain, X-ray film see bone density reduction. 3, discogenic lumbago: the pressure point is located in the interspinous process. Symptoms are aggravated by sedentary standing. [Treatment] (a) closed treatment: 1. prone position. 2. with a needle or a large headpin and other markers attached to the pressure point, film or C-arm X-ray machine fluoroscopy. Take the upper edge of the root of the transverse process as the target point.3. After routine disinfection of the skin, use a 7-gauge 8cm intracardiac injection needle to first pump 2% lidocaine hydrochloride 2ml, hit the dermatome and then vertically pierce into the target point, encounter the bone, that is, the base of the transverse process, slightly retracted, and then slightly tilt the end of the head into the needle to reach the original depth of the original depth of encountering the bone or the feeling of sliding down the bone from the bone surface, then prove that the tip of the needle is exactly at the upper edge of the transverse process, and then slightly retracted, depress the end of the needle diagonally to the medial side into the needle. Then slightly retreat the needle, depress the needle tail diagonally to the medial side into the needle, encounter the bone that is the outer edge of the upper articular process, slightly lifting insertion of the puncture needle, and the tip of the needle on the intersection of the upper articular process and the transverse process, the patient has a tingling pain or electric shock sensation, it means that the needle has arrived at the lumbar nerve after the expenditure of the fibrous hole of the bone, pumped back no blood into the 2% of Lidocaine 1 ml + Trimoxazol Acetate 1 ml. (2) Needle Knife Laxation: 1. Positioning with the same as before. 2. Puncturing the point of localization with the same as before. 3. The operation procedure is first to perform block according to the former method, and then stab the No.3 small needle knife according to the original approach, cut and peel 2~3 knives from the upper edge of the transverse process along the outer edge of the upper articular eminence in the upward and downward direction, and then exit the needle knife when there is a sense of loosening under the hand. (C) Other therapies: freezing, radiofrequency, chemical ablation and other methods are basically the same as the closure method, except that different means to achieve the purpose of blocking the posterior branch of the spinal nerve.1. The posterior branch of the lumbar nerve and the medial and lateral branches are accompanied by blood vessels, so when performing the laxation of the needle knife, the knife blade and the outer edge of the upper joints should be parallel and close to avoid damage to the blood vessels.2. Because of the wide range of anastomoses of the posterior branch of the lumbar nerve, the laxation of the nerve roots involves the neighboring 2-3 at the same time in order to achieve the best results. Because the posterior branch of the lumbar nerve has a wide anastomosis, the best results are achieved by involving 2-3 neighboring nerve roots at the same time. Patients with a long history of disease or those who cannot consolidate the effect of two blocks need to use needle knife to release.