Spondylolisthesis and spondylolisthesis in children usually do not cause symptoms, and many people seek medical attention for postural deformities or gait irregularities. Pain often occurs during the rapid developmental phase of adolescence and is overwhelmingly low back pain and occasionally leg pain. Symptoms worsen with strenuous activity or competitive exercise and decrease with restriction of activity or rest. Low back pain is usually due to instability of the involved segment, while leg pain is usually associated with irritation of the L5 nerve root. Signs vary with the degree of slippage. When slippage is significant, steps can be palpated in the lumbosacral region, lumbar spine motion is limited, and the N cord muscle is tense during straight leg raising. As the vertebral body shifts forward, compensatory anterior convexity develops above the slipped segment. The sacrum becomes more vertical, giving the hip a heart shape due to sacral protrusion. In more severe cases of slippage, the trunk becomes shorter, often resulting in complete loss of the lumbar contour line. Because of the N cord tension and lumbosacral kyphosis, the child walks with an odd spastic gait, which Newman describes as a “pelvic sway gait”. In children, unlike adults, there are few objective signs of nerve root compression, such as decreased muscle strength, altered reflexes, and sensory deficits, and N cord tension is often the only positive sign. In young patients with spondylolisthesis, scoliosis is more common and there are three types: 1. sciatica; 2. slipped; and 3. idiopathic. Sciatica scoliosis is a scoliosis of the lumbar spine due to muscle spasm and is usually not a structural scoliosis and can be eliminated when lying down or when symptoms are reduced. Sliding scoliosis is a twisted scoliosis of the lumbar spine with rotation, combined with a chipped spinal defect with asymmetric vertebral slippage. These lumbar scoliosis usually disappear after treatment of spondylolisthesis. Severe scoliosis may become structural and more complex to treat. seitsalo et al. found that lumbosacral row fusion did not correct thoracic or thoracolumbar curvature. If scoliosis and spondylolisthesis are present at the same time, they should be treated separately.