To compare the clinical efficacy and safety of musculoskeletal ultrasound-guided micro-needle knife combined with acupuncture versus simple acupuncture in the treatment of third lumbar transverse process syndrome.

A total of 60 patients with third lumbar transverse process syndrome admitted to our hospital from January to November 2025 were selected and divided into the study group (n=30) and the control group (n=30) by random number table method. Patients in the study group were treated with musculoskeletal ultrasound-guided targeted release of the third lumbar transverse process using micro-needle knife combined with acupuncture, while those in the control group were treated with simple acupuncture. The thickness and cross-sectional area of the affected L₃ multifidus muscle before and after treatment, as well as the total clinical effective rate, were compared between the two groups. The modified Oswestry disability index (ODI) was used to evaluate the lumbar function before and after treatment; the visual analogue scale (VAS) was used to evaluate the pain degree before and after treatment.

After treatment, the thickness and cross-sectional area of the affected L₃ multifidus muscle in both groups increased, and the study group showed a significantly better result compared to the control group (P<0.05); the ODI scores and VAS scores of both groups decreased, and the study group had lower scores (P<0.05); the total clinical effective rate of the study group was significantly higher than that of the control group (P<0.05).

The clinical efficacy of musculoskeletal ultrasound-guided micro-needle knife combined with acupuncture in the treatment of third lumbar transverse process syndrome is superior to that of traditional simple acupuncture. It can more effectively improve the morphology of the multifidus muscle, relieve pain, and enhance lumbar function, with definite curative effect and high safety.