1.Non-surgical treatment It is generally believed that non-surgical treatment is the treatment of choice for lumbar instability. Since the lumbar segment instability will eventually compensate itself to establish a re-stable state, some patients’ symptoms will disappear after non-surgical treatment due to the re-stable lumbar segments. Non-operative treatment results in good outcomes in 33% of patients (10-year follow-up), especially in older patients. Non-surgical treatment includes bed rest, reduction of the load on the intervertebral joints and lumbar back muscles, functional exercises for the lumbar back and abdominal muscles, medication, physiotherapy, aerobic rehabilitation, hormonal closure, lumbar brace protection, and brace immobilization. There are more methods used for soft tissue physiotherapy, such as heat therapy, hydrotherapy, wax therapy, ultrasound, tui na massage, and electrical stimulation. Hormonal closure is not recommended for frequent use, with greater risk of side effects and occurrence of epidural adhesions, hematoma, infection, etc. Small acupuncture treatment is not recommended because there are patients with serious complications such as nerve damage and hematoma that require surgical treatment. 2.Surgical treatment of lumbar instability The absolute indication for surgical treatment is progressive lower limb muscle weakness or cauda equina syndrome. For patients whose quality of life is still very poor after non-surgical treatment, surgical treatment can be carefully selected. There are several options available, but the principles and goals are the same: repositioning and decompression, internal fixation, bone graft fusion, release of nerve compression, correction of spinal deformity and strengthening of spinal stability. In order to prevent recurrence of deformity, nerve recompression, and to maintain segmental stability of the destabilized vertebral body after repositioning, internal fixation with the pedicle nail system, intervertebral fusion (Cage, TFC, and BAK) with autogenous cancellous bone fusion, and artificial ligament fixation may be used. The methods of implant fusion include postero-lateral PLIF, anterior intervertebral ALIF and transvertebral TLIF, and vertebral fusion devices include titanium, polyetheretherketone and allograft cortical bone. The surgical approaches include posterior approach, anterior approach, and transvertebral foramina. Currently, the posterior approach is more commonly used for internal fixation with intervertebral implant fusion, which is less invasive and has fewer complications. Strong osseous fusion is the fundamental guarantee of efficacy. Simple fixation without bone graft fusion will lead to failure, loosening and fracture of internal fixation sooner or later. We oppose the practice that orthopedic surgeons only pay attention to internal fixation, no bone graft fusion or no bone graft fusion. We advocate that reasonable and limited internal fixation and adequate bone graft fusion should be carried out according to the patient’s condition, financial ability, and actual needs of work and life, so as to reduce the patient’s financial burden and achieve the best curative effect is the goal we pursue. After all, Chinese farmers, wage earners and laid-off workers make up the majority of the population, and we cannot ask them to spend all their money on using various imported expensive materials, and we are against over-treatment by orthopedic surgeons. We use more domestic titanium arch nail rod systems plus intervertebral implants, intertransverse and interarticular implants, which can also achieve excellent results while greatly reducing the financial burden on the patient. At present, there is no evidence to prove that the combination of imported fixation devices and various internal fixation devices is better than the use of the arch root nail system alone or better than the domestic internal fixation materials, on the contrary, there is a large amount of literature at home and abroad reported that the internal fixation devices gradually loosen after 1 year, various metal materials rust seriously in vivo, clinical patients have back pain, soreness and swelling, hair plate and other symptoms, so regardless of domestic and imported devices, in vivo 1 year Therefore, regardless of domestic or imported instruments, they must be removed after 1 year in the body.