Chronic dislocation between adjacent lumbar vertebrae is called lumbar spondylolisthesis. It occurs at the level of the 4th and 5th lumbar vertebrae, and is caused by the displacement of the vertebral body caused by the fracture of the vertebral arch. The most typical manifestation of lumbar spinal stenosis is “intermittent claudication”, which refers to unilateral or bilateral lumbar pain and leg pain from the beginning of walking or after walking a certain distance (usually a few hundred meters). Lower limbs numbness and weakness, and even limp, but a little squatting or sitting down after a few moments of rest, the symptoms can quickly alleviate or disappear, the patient can continue to walk, and then walk for a period of time, the above symptoms reappear. Because in this process, the limp is intermittent, so it is called intermittent claudication. The appearance of intermittent claudication is mainly due to the pathological basis of the existing stenosis of the lumbar spinal canal, the increased pressure load on the vertebral body and nerve roots when upright, plus the stretching and contraction activities of the muscles of the lower limbs during walking to further promote the physiological congestion of the blood vessels in the nerve roots of the corresponding spinal ganglia in the spinal canal, followed by venous stasis and ischemic radiculitis due to the blockage of microcirculation in the corresponding areas after the nerve roots are strained, resulting in When the patient squats, sits down or lies down, the pressure load on the nerve root is reduced, the source of stimulation during muscle activity is eliminated, and the ischemic state of the spinal cord and nerve root is improved, so the symptoms are reduced and disappear. When walking again, the above-mentioned symptoms appear again, and then rest, the symptoms are relieved again, and so on, alternately, forming intermittent claudication. Lumbar isthmus fracture The following diagrams show what is happening to the lumbar spine: Figure 1: Lumbar isthmus fracture side posterior view The cause of lumbar spine slippage often stems from congenital isthmus dysplasia of the vertebral arch, combined with acquired trauma or chronic strain injury, causing the isthmus to fracture. The “separated part of the vertebral arch” shown by the arrow in Figure 1 is the isthmus fracture. Figure 2: The upper view of the lumbar isthmus fracture From Figure 2, it can be seen that the weakest part of the vertebral arch is the isthmus, and once the dysplasia or congenital underdevelopment causes discontinuity, coupled with acquired external factors, it is very easy to separate and slip. Figure 3: Lumbar isthmus crack, the vertebral body force forward slip Figure 4: X-ray performance of lumbar slippage Lumbar oblique (45 degrees) film, lumbar isthmus crack especially like “dog wearing a necklace”. Figure 5: Grading of lumbar spondylolisthesis The degree of lumbar spondylolisthesis can be used to estimate the degree of compression of the lumbar spinal canal contents, i.e., the cauda equina, to select the appropriate treatment and to estimate the prognosis. Figure 6: Lumbar spinal stenosis caused by lumbar spinal slippage Since the physiological curvature of the human lumbar spine is forward, the 4th and 5th lumbar vertebrae have a mild anterior tilt. If the lumbar isthmus is broken, the affected vertebra and the spinal segment above it will slip forward (as in Figure 3), causing compression of the cauda equina nerve and surrounding tissues, the contents of the lumbar spinal canal, resulting in the manifestation of lumbar spinal stenosis – -intermittent claudication. Chinese medicine treatment and health care of lumbar spondylolisthesis 1, massage therapy: to be carried out in regular hospitals by massage specialists mainly in the back along both sides of the spine, the rear side of the lower limbs to implement massage techniques to relieve tight or spastic muscles of the waist and legs and relieve pain. 2, small acupuncture treatment: to the hospital by the orthopedic surgeon according to the condition, with small acupuncture needles (as thick as acupuncture needles, the front with an edge) into the corresponding affected area, in order to release the nerve compression, separation of soft tissue adhesions, relieve muscle tension. The treatment is carried out under local anesthesia, with little pain and minimal damage to the patient; it is highly targeted and accurately positioned, with immediate effect. 3. Internal and external treatment of traditional Chinese medicine: the treatment is based on dialectical evidence, with the method of tonifying the liver and kidney and relaxing the tendons and activating the ligaments, and the prescriptions are Jin Kui Kidney Qi Pill, Liu Wei Di Huang Wan and Dou Wu Xie Sheng Tang. Externally, the herbs are used to activate blood circulation and eliminate blood stasis, activate the ligaments and relieve pain, and the dregs are taken after soaking in wine and heated and applied externally to the lumbar region. 4.Surgical treatment if necessary Use metal internal fixation to fix the slipped and adjacent vertebrae. 5, health care functional exercise supine bed, try to bend the knees and hips, with two fingers crossed hold both knees in front of the chest, so that the lumbar vertebrae are flexed, the next person standing on the side of the bed, with one palm to hold the patient’s feet bottom, the other palm to hold the patient’s neck and back, while the hands force, ask the patient to cooperate with the force, for back and forth rolling 10 ~ 30 times. Do this exercise 2 times a day. Patients can also practice such “not falling over” exercise on their own, the number of practice should be from little to much, from light to heavy, gradually increase the amount of exercise, do not rush to achieve. Figure 6: “not inverted woon exercise” Patients with lumbar spondylolisthesis pay attention to cold and warmth, avoid living in a humid environment for a long time; when lumbar pain attacks, you can wear a medical waist brace for protection; young patients avoid strenuous running, jumping, throwing and other sports, swimming sports are good for relaxing the muscles of the lumbar back. The key is to seek medical attention in a timely manner to clarify the diagnosis, develop a treatment plan and health care measures.