If there are no obvious symptoms of lumbar spondylolisthesis and nerve compression, conservative treatment is not needed, and surgery is needed only when there are obvious complications, and there are minimally invasive surgery and traditional surgery. 1. Conservative treatment: Lumbar 5 bilateral isthmic fracture of the arch can be treated conservatively if the situation is not serious, and does not require surgical treatment. Conservative treatment mainly consists of bed rest, and if the pain is obvious, oral non-steroidal anti-inflammatory drugs (NSAIDs) such as Celecoxib can be taken to relieve the pain, and most of the cases can be recovered through conservative treatment. 2. Surgery: Surgery is required only when there are obvious symptoms of lumbar spondylolisthesis and nerve compression. Surgery is mainly to solve the complications, not to treat the spondylolisthesis. There are minimally invasive surgery and traditional incision surgery, etc. Depending on the condition, you can choose the appropriate treatment. It is recommended to have a detailed examination in time to determine the treatment plan for lumbar 5 bilateral isthmus of the arch.