How is lumbar spondylolisthesis treated? For lumbar spondylolisthesis and degenerative lumbar spondylolisthesis found incidentally without symptoms, no treatment is needed, only active strengthening of lumbar back muscle exercises to enhance the stability of the lumbar spine, and reducing or avoiding heavy work with bending and weight bearing to prevent further aggravation of the spondylolisthesis and prevent the resulting symptoms such as low back pain and radioactive pain and numbness of both lower limbs. Most patients with lumbar spondylolisthesis who have only lumbar pain can effectively relieve their symptoms through conservative treatment methods. The contents include bed rest, lumbar heat physiotherapy, lumbar girth immobilization, oral anti-inflammatory and analgesic drugs and herbal medicines to activate blood circulation, and strengthening of lumbar back muscle exercises. In the case of isthmic collapse lumbar spondylolisthesis with recurrent lumbar pain, only a few young patients need to be treated with surgery. After lumbar spondylolisthesis gradually progresses, lumbar spinal stenosis can occur, compressing the lumbar nerve roots, resulting in symptoms such as radiating pain and numbness in both lower limbs and intermittent claudication, and in severe cases, the patient is unable to walk. Degenerative lumbar spondylolisthesis is one of the important causes of lumbar spinal stenosis, which is a progressive lesion and usually does not stabilize on its own, and most patients require surgery to effectively relieve the above symptoms because conservative treatment is ineffective. What are the principles and methods of surgery for lumbar spondylolisthesis? There are different surgical approaches for different types of lumbar spondylolisthesis. Doctors should make reasonable treatment recommendations based on the patient’s specific situation. The current principles of surgical treatment for lumbar spondylolisthesis are: repositioning, decompression, internal fixation, and bone graft fusion. The repositioning refers to the use of surgical release combined with instrumentation to restore the slipped vertebral body to its original normal position; decompression in most cases refers to the use of laminectomy, nerve root canal opening and other methods to release the compression of nerve roots and cauda equina nerve and relieve the patient’s lower limb pain and numbness; internal fixation refers to the use of appropriate internal fixation methods to maintain the normal position of the repositioned vertebral body and prevent the recurrence of vertebral slippage or lumbar spine However, internal fixation can only provide short-term stability after lumbar spine surgery, and its long-term stability eventually needs to rely on bone graft fusion to achieve. Most orthopedic surgeons currently use pedicle screw fixation systems to achieve these goals, and some patients may use interbody fusion alone or simultaneously to enhance the stability of the spine after surgery and to increase the rate of spinal implant fusion. These procedures have been proven in a large number of clinical cases to be relatively satisfactory, with high patient satisfaction, and have become a mature standard procedure.