The so-called lumbar triple transverse process syndrome is called lumbar triple transverse process syndrome, which is caused by external forces such as weight-bearing and sudden twisting of the lumbar region, resulting in damage to the tendons, ligaments and fascia attached around the lumbar triple transverse process, causing local exudation, adhesions, nodules and passive spasm of the erector spinae muscles, resulting in pain in the lumbar region, buttocks and posterior and lateral thighs. I. Local anatomy The three transverse processes of the lumbar region are the longest in the entire lumbar spine and play a major balancing role in the five lumbar vertebrae. If the thoracic eleventh, twelfth and free ribs are taken out together with all the lumbar vertebrae and sacrococcygeal vertebrae, the shape of which is like a model airplane, then the lumbar triple transverse process is like the wings on both sides of the airplane. When the human body bends and moves, bends forward and tilts back, the three transverse processes of the lumbar region are the main balancing act. Local muscles: from superficial to deep: superficial, middle fascia, latissimus dorsi, longest muscle of the erector spinae, the outer side of which is the lumbar square muscle, under the transverse process. The deeper layer in front of it is the psoas major muscle. The superficial and middle layers of fascia form a sheath of the erector spinae muscle. The middle layer of the thoracolumbar fascia is attached to the tip of the transverse process of the lumbar vertebrae. Etiology: weight-bearing on the lumbar region → sudden twisting → muscle strain around the lumbar truncus → local capillary rupture and bleeding and soft tissue inflammatory exudation → local adhesions of the lumbar truncus → formation of nodal scar → spasm of the erector spinae → symptoms. L3 is located at the apex of the lumbar physiological pronation and is the hub of lumbar extension and flexion, rotation and lateral bending activities. In the lumbar region, the L3 transverse process is the longest, curved and active, and the lever force is also the largest, so it is subjected to the greatest pulling stress in sports; because the transverse process is attached to many muscles, and the muscle force direction is different, there are also fascia, tendon membrane, ligaments, etc., which are subjected to huge tensile stress; in intense labor, sports or long-term fixed position work, these muscles are difficult to coordinate; thus, the L3 transverse process The soft tissues attached around the transverse process of the 3rd lumbar vertebra are most vulnerable to injury in the event of bull, flash, contusion and other injuries. In acute injury, the fascia, ligaments, muscles and other tissues attached to the L3 transverse process can undergo partial tearing, bleeding, tissue exudation, edema and other changes (some even cause avulsion fractures of the L3 transverse process). Clinical manifestations: 1. Mostly seen in young and strong manual laborers, unilateral and bilateral onset. 2. Low back pain, which may radiate to the buttocks and posterior lateral thighs. 3. It is aggravated after activity or activity and relieved after rest. 4.Bowing test becomes positive, and the symptoms are aggravated by the side of the body to the opposite side. 5.The pressure pain in the area of the third transverse process of the lumbar region is obvious, and even a positive nodule (a single nodule fixed on the transverse process) can be palpated, and the flick test is positive. Differential diagnosis Differentiation from lumbar disc herniation: 1. There are more joint synapses and spinous process pressure pains in lumbar disc herniation, and more transverse process pressure pains in lumbar triple transverse process syndrome. 2. The positive nodes of lumbar triple transverse synovial syndrome are single, while the positive nodes of lumbar disc herniation are generally nodeless. 3. The straight leg raise test is positive for lumbar disc herniation. 4, CT examination can confirm the diagnosis.