The more familiar common diseases such as lumbar disc herniation and lumbar spinal stenosis were able to be treated with minimally invasive methods long ago. Now, another complex degenerative disease of the lumbar spine, lumbar spondylolisthesis, can also be treated by minimally invasive surgery, which is undoubtedly a blessing for patients! Lumbar spondylolisthesis is a condition in which the patient’s lumbar vertebrae (or vertebrae) are not in their original normal position and have moved some distance to the front, or to the back. The causes are mostly developmental defects of the spine, trauma and degenerative changes in the intervertebral junction structures. The mechanism causing the patient’s pain is either pressure on the nerves from the displaced spine, or excessive tissue tension due to spinal instability. Non-surgical treatments such as rest can only relieve symptoms; the only means of a radical cure is surgical repositioning and fixation, and eventually allowing adjacent vertebrae to grow together and fuse to achieve a state of permanent fixation and stability. The name of the surgery is called lumbar spine repositioning and fusion. So far, most surgeons have turned over the muscles of the lumbar region, extensively removed important structures such as the articular processes and laminae of the spine, placed screws in the vertebrae (pedicles), relied on the strength of the screws to restore the displaced vertebrae to their original position, and then placed a support device between the two vertebrae to increase stability, while implanting bone tissue to promote growth and fusion. The surgery is very traumatic for the patient and requires a long period of rehabilitation after the surgery. A small number of patients do not fully recover from the damage caused by the surgery and are left with sequelae. Spine surgeons have been exploring minimally invasive methods to replace this open surgical approach. The recent maturation of two technologies in the field of spine surgery, minimally invasive lumbar interbody fixation and fusion and percutaneously placed pedicle screw fixation, has made this aspiration possible. The process of installing the intervertebral device and implanting bone through a small incision is relatively easier to achieve. With the help of improved lighting, special pulling hooks and delicate tools, and some surgical experience, the surgeon can perform the procedure with great delicacy. Progress in minimally invasive lumbar intervertebral fixation and fusion techniques has been relatively smooth. Due to the scattered location of the placed screws, the open nail placement surgery has a long skin incision and, more seriously, the muscles on both sides of the spine have to be turned over to expose the vertebral surfaces before the screws can be threaded in. Moreover, the exposed portion of the screw is lifted up after the nail is placed, resulting in the turned muscle never returning to its original position, and the artificially created gap is eventually filled with scar tissue. The stripping process itself is a serious injury to the muscle. With percutaneous screw placement, the screws are inserted through the skin directly into the pedicle under the guidance of x-ray imaging equipment, which causes minimal damage to the body. Each screw is inserted using a separate orifice, without opening the muscle. Therefore, the percutaneous pedicle screw fixation technique has made the greatest contribution to reducing surgical injuries and is the greatest advancement in minimally invasive spine surgery. Returning a displaced vertebra to its original position using a percutaneous pedicle screw system is a more complex technical challenge that requires redesign of the tool. In addition, it requires a high degree of surgical skill on the part of the surgeon. Currently, only a few surgeons, even in developed countries, are able to master this technique. Some doctors in China are more experienced and have developed a unique experience to solve the defect of insufficient screw lifting and repositioning power. Minimally invasive technology for the treatment of lumbar spondylolisthesis is definitely more than just a small skin incision. The important thing is that the patient no longer has to worry about the surgery destroying the original structure of the spine.