Minimally invasive lumbar spine surgery has gradually become the mainstream of lumbar spine surgery treatment. The traditional posterior median approach of decompression and fixation for lumbar spine surgery for lumbar spondylolisthesis and lumbar spinal stenosis has the disadvantages of long incision, large injury and slow recovery, especially for multi-segmental lumbar spine surgery, extensive muscle stripping often leads to muscle atrophy and fibrosis, which often leads to postoperative lumbar weakness, pain and discomfort. To further reduce surgical trauma and improve outcomes, in 2002, Foley et al. first reported minimally invasive surgery (MIS) TLIF for the treatment of many lumbar spine disorders including lumbar spinal stenosis, lumbar spondylolisthesis, and postoperative recurrence of lumbar spine. This surgical approach pioneered minimally invasive surgery for lumbar spondylolisthesis. The procedure is a combination of two main techniques: Percutaneous minimally invasive placement of pedicle screws: the screws are placed through a 1-2 cm long incision under X-ray fluoroscopy, and the pedicle screws are placed with minimal damage, without stripping the muscle tissue. 2. Minimally invasive decompression and bone graft fusion: The surgery is performed using minimally invasive channels for decompression of the spinal canal, and the single-segment surgical incision is only about 3 cm, much smaller than conventional surgical incisions. What’s more, the intermuscular approach can be used without extensive stripping of muscle tissue. The combination of these two techniques allows for spinal canal decompression, interbody bone grafting and lumbar spine fixation with minimal surgical trauma. This surgical approach is less invasive, less bleeding, less painful postoperative incisions, faster recovery, and shorter hospital stays, making it extremely suitable for both young and elderly patients. The widespread development of minimally invasive surgery in recent years has heralded the eventual replacement of open surgery for lumbar spondylolisthesis by minimally invasive surgery. Pre-operative CT of a typical case of lumbar spondylolisthesis Post-operative picture Surgical incision