Lumbar spondylolisthesis is a partial or complete slippage of the upper vertebral body on the surface of the lower vertebral body that occurs due to abnormal intervertebral connections. Simply put, a lumbar slip is the forward or backward displacement of one vertebral body over another vertebral body. Lumbar spondylolisthesis is usually an anterior slip. Posterior slippage occurs in the lumbar 5 and lumbar 4 vertebrae, accounting for about 95%, with the incidence of 82-90% in the lumbar 5 vertebrae and rare in other lumbar vertebrae. Some traumatic or degenerative slippage can occur simultaneously in multiple segments, even with posterior slippage. Etiology The cause of lumbar spine slippage can be congenital (present at birth) or acquired, occurring in childhood or later. It is primarily caused by excessive mechanical stress of various kinds, and contributing factors include lifting heavy objects, weight lifting, soccer, sports training, trauma, wear and tear. There is another type of lumbar spondylolisthesis that is degenerative, meaning that structural abnormalities occur due to the aging of various structures in the lumbar spine, usually occurring after the age of 50. Symptoms When a lumbar spondylolisthesis occurs, the patient may have no symptoms, but may be detected only when a radiograph is taken, or may have various related symptoms, such as low back pain, lower extremity pain, numbness, weakness, and in severe cases, abnormal urination and defecation. Patients with more severe slippage may experience depression of the lumbar region, convexity of the abdomen, and even shortening of the trunk and swaying when walking. If there is no significant aggravation of lumbar spondylolisthesis, conservative treatment can be adopted, and lumbar spine X-rays can be reviewed regularly to understand the condition of the spondylolisthesis. If there is back pain and leg discomfort, the symptoms can usually be relieved after rest. Treatment The treatment of lumbar spondylolisthesis should be based on the strategy of medication as the main treatment, supplemented by physical therapy (e.g. acupuncture, massage, tui na, etc.). In addition to taking medication, it is also important for the patient to maintain health care in daily life, such as taking more walks after dinner and exercising more often, which are very helpful for the patient’s recovery. Conservative treatment includes bed rest for 2-3 days, prohibition of weight-bearing activities such as lifting heavy objects and bending over, combined with physical therapy such as infrared and heat therapy, and oral anti-inflammatory and pain-relieving drugs such as ibuprofen and fenbendazole. In addition, you can also wear a lumbar brace and support, which can reduce the burden on the lumbar area and relieve the symptoms. If patients with lumbar spondylolisthesis have neurological symptoms, and the symptoms are not significantly relieved by regular conservative treatment, and still have long-term lumbar pain and other concomitant symptoms of spondylolisthesis, that is, conservative treatment is ineffective and seriously affects life and work, surgery should be considered. There are many kinds of surgical methods for lumbar spine slippage, such as posterior slippage repositioning, pedicle screw internal fixation, intervertebral implant fusion, etc. What are the methods of lumbar spine slippage treatment? Patients with more severe slippage may experience lumbar depression, abdominal protrusion, or even trunk shortening and swaying when walking. If there is no significant aggravation of lumbar spondylolisthesis, conservative treatment can be adopted, and lumbar spine X-rays can be reviewed regularly to understand the slippage. If there is back pain and leg discomfort, the symptoms can usually be relieved after rest. The causes of lumbar spondylolisthesis are not yet clear, and numerous studies have shown that congenital developmental defects and chronic strain or stress injury are two possible important causes, with the latter generally considered to be the main cause. Traumatic The lumbar isthmus can be acutely fractured by acute trauma, especially posterior extension trauma, mostly seen in athletic sports sites or strong labor porters. Congenital genetic factors The lumbar spine is born with vertebral body and arch ossification centers, and each side of the arch has two ossification centers, one of which develops into the superior articular eminence and arch root, and the other develops into the inferior articular eminence, plate, and half of the spinous process. If the two do not heal, a congenital isthmus collapse (spondylolysis), also known as an isthmic discontinuity, is formed, with localized pseudoarticular-like changes. After walking, the spine above may slide forward due to standing, which is called spondylolisthesis; spondylolysis may also occur due to abnormal development of the upper sacral or L5 arches, without isthmus breakdown. Fatigue fracture or chronic strain injury From a biomechanical point of view, the human body is in a standing position and the lower lumbar spine is heavily weighted. The fractional force that causes forward displacement acts on the isthmus where the bone is relatively weak, and the long-term repeated action can lead to fatigue fracture and chronic strain injury. Degenerative factors As a result of prolonged and continuous lower back instability or stress increase, the corresponding small joints wear and tear, degenerative changes occur, joint protrusion becomes horizontal, coupled with intervertebral disc degeneration, intervertebral instability, anterior longitudinal ligament relaxation, thus gradually slipping, but the isthmus remains intact, so also known as pseudoslip. The incidence of slippage is mostly seen after the age of 50, and the incidence in women is three times that of men, mostly in L4, followed by L5 vertebrae, and the degree of slippage is generally within 30%. Pathological fractures are systemic or localized lesions involving the vertebral arch, isthmus, and superior and inferior synapses, resulting in loss of structural stability of the posterior vertebral body and pathological slippage. Local bone lesions can be tumors or inflammatory diseases. Exercise methods For patients with lumbar spondylolisthesis, the ability to perform sports depends on the patient’s condition. Generally speaking, during the acute attack of lumbar spondylolisthesis, rest in a hard bed and appropriate treatment must be taken, and sports are absolutely prohibited. During the remission period of the acute attack of lumbar spondylolisthesis or in patients with only mild symptoms, they can participate in sports appropriately [1], but they should exercise slowly and control the amount of activity appropriately, and progress gradually. Sudden and strenuous exercise is not allowed, and the sports items should be selected, and sports items with relatively less lumbar activity and load should be chosen at the beginning, and protective measures such as wearing a wide belt or lumbar girth should be taken during exercise. (1) five-point exercise during the recovery period of lumbar disc herniation (1) five-point supine, two lower limbs straight, two heels, two elbows a few head back on the ground, try to lift the chest for 3-5 seconds, repeat 10 times; (2) half bridge supine, two legs bent 90 °, two upper limbs naturally relaxed straight, and then the hips, back lift 5-10 seconds, repeat 10 times; (3) flying swallow prone, two lower limbs and upper limbs straight and even head lift 3-5 seconds, repeat 5 times; (4) flying swallow, two lower limbs and upper limbs straight and head lift 3-5 seconds, repeat 5 times. -(4) squatting stand, both upper limbs relax naturally or hold the back of the head with both hands, then squat for 3-5 seconds, then stand, repeat 5 times; (5) bending type stand, cross your arms, bend downward, the maximum degree of 90 °, repeat 20 times; (6) back extension stand, cross your arms, do back extension, repeat 10 times. Attention Patients with lumbar spondylolisthesis should maintain correct posture at work, and can massage the waist and legs from time to time, or do gymnastics to relieve the tension of the lumbar muscles. Maintain good living habits, prevent the waist and legs from getting cold, and prevent overexertion. If there are symptoms of nerve root compression, decompression of the nerve root canal and spinal canal is also needed, so as to eliminate the pain and numbness of the lower limbs caused by lumbar spondylolisthesis, etc. Pay attention to rest. Rest can enable the release of the tension and pressure accumulated in various parts of the body, ensure body coordination and reduce the chance of various acute pains.