Lumbar spondylolisthesis is a disorder in which the lumbar vertebrae are partially or completely misaligned, and is generally referred to clinically as a slipped vertebra, generally a forward slippage of the superior vertebra. The incidence of lumbar spondylolisthesis is 3-7% in Europe, and there is a lack of accurate statistics in China. It is generally believed that routine X-ray examination of patients with low back pain reveals a tendency for about 5% of adults to suffer from lumbar spondylolisthesis. At present, the etiology of lumbar spondylolisthesis is still very unclear. The most common cause of lumbar spine slippage is degenerative lumbar spine slippage that occurs with increasing age, also known as pseudoslippage; followed by lumbar spine slippage due to sports injury, congenital or unknown causes of lumbar spine isthmus collapse, also known as true slippage; lumbar spine slippage occurs between lumbar 4~5 vertebrae and between lumbar 5~sacral 1 vertebrae. Degenerative lumbar spondylolisthesis is due to long lasting lumbar instability, which causes degenerative changes in the corresponding small joints, and the joint protrusion becomes horizontal, coupled with intervertebral disc degeneration, which makes the connection between vertebrae become loose and unstable, and lumbar spondylolisthesis gradually occurs. This disorder is also called pseudoslip because the isthmus remains intact. Mostly seen after the age of 50, more women than men, mostly occurring in the lumbar 4 vertebrae forward slip, followed by the lumbar 5 vertebrae forward slip. The degree of degenerative lumbar spine slippage is generally mild, mostly within 2 degrees of slippage. The lumbar slippage caused by the lumbar isthmus collapse is called lumbar true slippage, the cause of the isthmus collapse is not very clear, it may be related to the narrow and weak isthmus during the development of the lumbar spine, on this basis, the isthmus is easy to fatigue fracture and fracture, after which the fracture does not heal, forming the isthmus collapse; it may also be caused by trauma to the lumbar spine during adolescence; there are also some young athletes who often do lumbar back extension movements Adolescent athletes are also prone to lumbar isthmus fractures, which may be related to repeated injurious stimulation of the isthmus during lumbar back extension. The isthmic fracture may not appear in the early stage, but after many years of isthmic fracture, the lumbar spine may gradually slip due to the destruction of the stable structure of the lumbar spine, and the degree of lumbar spine slip can be very serious over time. True slippage of the lumbar spine caused by lumbar isthmic fracture occurs between the lumbar 4 to 5 vertebrae and between the lumbar 5 to sacral 1 vertebrae, and is most common in adults and rare in children. Most lumbar spondylolisthesis is asymptomatic and is often discovered unintentionally during a physical examination and radiograph. However, some patients with lumbar spondylolisthesis can gradually develop symptoms of low back pain and radiating pain and numbness in the lower extremities over time. Not every patient with lumbar spondylolisthesis and isthmus collapse requires treatment. Only 30% of patients with lumbar spine slippage confirmed by X-ray will develop symptoms. For isthmic collapse lumbar spine slippage and degenerative lumbar spine slippage that are not found by chance, no treatment is needed, only active strengthening of lumbar back muscle exercises to enhance the stability of the lumbar spine, reducing or avoiding heavy work with bending over to prevent further aggravation of the slippage and prevent the resulting low back pain and radiating pain and numbness of both lower extremities, etc. symptoms. However, with the passage of time, as the lumbar spine degeneration and aging accelerates, there may also be recalcitrant lumbar pain and symptoms such as radioactive pain and numbness in the lower extremities, at that time, surgery will be required, but the surgical technique should have improved considerably compared to now. Most patients with lumbar spondylolisthesis who have only low back pain can effectively relieve their symptoms through conservative treatment methods. The contents include bed rest, lumbar heat physiotherapy, lumbar girth immobilization, oral anti-inflammatory and analgesic drugs as well as herbal medicines for activating blood circulation, and strengthening the lumbar back muscle exercises. In the case of isthmic collapse lumbar spondylolisthesis with recurrent lumbar pain, only a few young patients need to be treated with surgery. After lumbar spondylolisthesis gradually progresses, lumbar spinal stenosis can occur, compressing the lumbar nerve roots, resulting in symptoms such as radiating pain and numbness in both lower limbs and intermittent claudication, and in severe cases, the patient is unable to walk. Degenerative lumbar spondylolisthesis is one of the important causes of lumbar spinal stenosis, which is a progressive lesion and generally does not stabilize on its own, and most patients are ineffective in conservative treatment and require surgery to effectively relieve the above symptoms. When lumbar discomfort is detected, a hospital visit should be made. Generally, ancillary tests are not very expensive, and an ordinary X-ray or a double oblique image of the lumbar spine is sufficient for a clear diagnosis. However, when the condition is complicated, such as combined lumbar disc herniation, lumbar spinal stenosis or exclusion of lumbar spine pathology, further lumbar hyperextension and hyperflexion films should be taken to observe the stability of the slipped vertebrae, and CT and MRI examinations are also needed to understand the nerve root compression. There are different surgical methods for different types of lumbar spondylolisthesis. The doctor should make reasonable treatment recommendations according to the patient’s specific situation. The current principles of surgical treatment for lumbar spondylolisthesis are: repositioning, decompression, internal fixation, and bone graft fusion. Displacement refers to the use of surgical release combined with instrumentation to restore the slipped vertebral body to its original normal position; decompression in most cases refers to the use of laminectomy, nerve root canal opening and other methods to release the compression of the nerve roots and cauda equina nerve and relieve the patient’s symptoms of lower limb pain and numbness; internal fixation refers to the use of appropriate internal fixation methods to maintain the normal position of the reset vertebral body and prevent the recurrence of vertebral slippage or instability of the lumbar spine. However, internal fixation can only provide short-term stability after lumbar spine surgery, and its long-term stability eventually needs to rely on bone graft fusion to achieve. Most orthopedic surgeons currently use pedicle screw fixation systems to achieve these goals, and some patients may use interbody fusion alone or simultaneously to enhance the stability of the spine after surgery and to increase the rate of spinal implant fusion. These procedures have been proven in a large number of clinical cases to be relatively satisfactory, with high patient satisfaction, and have become a mature standard procedure.