Often outpatients come with films of lumbar spondylolisthesis to inquire about the suitability of surgery. Lumbar spondylolisthesis is only an imaging manifestation that has some correlation with clinical manifestations, but there is no positive correlation. In clinical practice, a portion of lumbar spondylolisthesis has no clinical manifestation and is only detected when doing examinations. Such cases do not require any treatment and only need to be observed. Medical intervention is required only when the corresponding clinical symptoms (back and leg pain, intermittent claudication) due to lumbar spondylolisthesis occur. However, most of them only require functional exercises, symptomatic treatment with medication or physiotherapy, and lumbar circumference protection if necessary. As for the problem of “paralysis” that some people are concerned about, there is no need to worry about it at all. Because the development of the lesion is a gradual process, the speed and degree of development of the disease varies from person to person, and in a considerable number of cases the disease does not aggravate with age, rather some cases can obtain lumbar spine self-stabilization through hyperplasia, so there is no need for the so-called “preventive surgery”. Only a small percentage of lumbar spondylolisthesis requires surgical treatment. Surgery should be considered in the following cases: 1. Nerve damage: for example, numbness of the lower limbs for a long time, significant loss of muscle strength in some muscles and corresponding functional impairment; urinary and bowel dysfunction, etc. 2, the symptoms are heavy, affecting normal work and life, and non-surgical treatment is ineffective. The clinical manifestation of lumbar spondylolisthesis is rather characteristic, generally most of the symptoms disappear when resting, even like normal people. While standing and walking activities appear back and leg pain, especially intermittent claudication.