True lumbar spondylolisthesis: the portion between the upper and lower articular processes of the lumbar vertebral arch is called the isthmus. The interruption of the continuity of the bone between the vertebral arch or isthmus on one or both sides of the lumbar vertebrae due to congenital developmental malformation, traumatic fracture, chronic injury, etc. is called isthmic discontinuity or vertebral disintegration. On the basis of isthmic discontinuity, once the affected vertebra is subjected to external force, together with the above lumbar vertebra, the lumbar spine slips forward, causing the lumbar spine slip is called true lumbar spine slip. If there is no isthmus discontinuity and the lumbar spine slipped due to other reasons, it is called pseudolumbar spine slippage. True lumbar spondylolisthesis is most often seen in adults aged 30 to 40 years old, with approximately equal incidence in men and women. It mostly occurs in the 5th lumbar vertebra, followed by the 4th lumbar vertebra, and there are also multiple cases. Symptoms: Long-term recurrent lower back pain, sometimes radiating to the sacroiliac region and even to the lower limbs. The pain increases when standing, walking, bending and bearing weight, and decreases when resting in bed. Very few heavy patients may have symptoms of strain and compression of the cauda equina nerve, weakness of the lower limbs, numbness in the saddle area, dysfunction of urination and defecation, and even incomplete paralysis. If there is only isthmus disintegration without slippage, sometimes there are no symptoms, some have mild lower back pain and can perform general labor. The degree of patient symptoms depends on the type of isthmic discontinuity, the spinal instability, the degree of slippage and the age of the patient. Pseudolumbar spondylolisthesis: The stability of the lumbar spine is maintained by two interrelated aspects, the spine itself and the muscular aspects associated with it. Damage or dysfunction in either of these aspects can produce segmental instability of the lumbar spine. The lower lumbar intervertebral joints that do not maintain physiological alignment under normal loading, causing loosening and instability, and even signs of lumbar spondylolisthesis and a series of symptoms, are called lower lumbar instability. It is also called “pseudolumbar spondylolisthesis” because it is not accompanied by the collapse of the vertebral arch isthmus. The disease is mostly seen in women around 60 years old, with the 4th and 5th lumbar vertebrae being the most common. The causes of “pseudolumbar spondylolisthesis” are mainly the following: 1. degenerative changes: due to dehydration and degeneration of the intervertebral disc, its volume shrinks and the corresponding vertebral space narrows, resulting in the relaxation of the anterior and posterior longitudinal ligaments. In forward flexion, back extension, can not restrain the normal movement of the vertebral body, resulting in excessive forward or backward movement of the upper vertebral body, resulting in vertebral body pseudoslip. 2, endocrine disorders: endocrine changes in women during menstruation or menopause, causing osteoporosis at the same time, so that the ligaments and joint capsule relaxation and elasticity weakened and lumbar spine slippage, so women after menopause is more common. Symptoms: The symptoms of slippage are not obvious in mild cases, but in severe cases, there is more lumbar pain, pain points are mostly in the lumbar area and buttocks, pain characteristics are soreness, pulling pain, swelling pain, patients feel their lumbar area seems to be “broken”, especially after standing for a long time is more obvious. Due to the instability of the vertebral body, many people are reluctant to stand for a long time or rely on other objects or hold the waist with both hands when standing to reduce the load on the lumbar region. Because of the pseudoslip of the 4th and 5th lumbar vertebrae, the 5th lumbar nerve is mostly involved, and the skin sensation of the lateral calf is reduced, and the knee tendon reflex and Achilles tendon reflex may also be weakened, but the symptoms disappear or are reduced immediately after lying down. The duration of the disease can be as short as a few days or as long as several decades. Some patients also have intermittent claudication with pain that is pronounced during walking and relieved after sitting or lying down. The diagnosis of this disease is ultimately determined by x-rays. Power lateral films should be taken as a basis for diagnosis and as one of the criteria for determining the effectiveness of treatment.