Lumbar spondylolisthesis is a common orthopedic disease, mostly seen in women around 60 years old, with the 4th and 5th lumbar vertebrae being the most common. The causes of “lumbar spine slippage” are mainly the following: ① Degenerative changes: due to dehydration and degeneration of the intervertebral disc, the corresponding vertebral space becomes narrower, resulting in laxity of the anterior and posterior ligaments. During forward flexion and backward extension, the normal movement of the vertebral body cannot be restrained, resulting in excessive forward or backward movement of the upper vertebral body, causing vertebral slippage. ②Endocrine disorders: endocrine changes in women during menstruation or menopause, causing osteoporosis at the same time, so that the ligaments and joint capsule relaxation and elasticity weakened and lumbar spine slippage, so women after menopause is common. The symptoms of slippage are not obvious in mild cases, but in severe cases, there is mostly lumbar pain, mostly in the lumbar region and buttocks, and the pain is characterized by soreness, pulling pain, swelling, numbness or burning heat, not related to weather changes. Patients feel as if their lumbar area is “broken”, especially after standing for a long time, which is more obvious. Due to the instability of the vertebral body, the patient is reluctant to stand for a long time or rely on other objects or hold the waist with both hands to reduce the load on the lumbar region. There may be reduced sensation in the skin of the lateral calf, and the knee tendon reflex and Achilles tendon reflex may also be reduced, but the symptoms disappear or are alleviated immediately after lying down. The duration of the disease can be as short as a few days or as long as several decades. Some patients also have intermittent claudication, with pain evident during walking, weakness in walking, and pain relief after sitting or lying down. The diagnosis of this disease is ultimately determined by x-rays. Power lateral films should be taken as a basis for diagnosis and one of the criteria for determining the effectiveness of treatment. Since lumbar spondylolisthesis has its unique pathological anatomical changes and radiological imaging features, it is relatively easy to be diagnosed among the various causes of low back pain, and its treatment is as follows: 1. Not all lumbar spondylolisthesis requires treatment Some doctors believe that all lumbar isthmic fissures require surgical treatment to prevent further lumbar spondylolisthesis, aggravation of symptoms and nerve compression. In fact, some patients with lumbar isthmic spondylolisthesis do not develop lumbar pain symptoms until old age, and even some patients with mild spondylolisthesis remain untreated throughout their lives because they have no lumbar pain symptoms. Studies have shown that the degree and type of chronic low back pain in patients with acquired lumbar spondylolisthesis is not substantially different from that of normal individuals. Recent studies suggest that the incidence and severity of low back pain in the middle-aged population with a mild or moderate x-ray diagnosis of lumbar spondylolisthesis is not different from those without lumbar spondylolisthesis. Therefore, mild lumbar spondylolisthesis is not necessarily the root cause of lumbar pain, and there is no need for occupational restriction for those without lumbar pain, let alone the need for surgery. 2. Not all lumbar spondylolisthesis with lumbar pain requires surgery For patients with lumbar spondylolisthesis with symptoms of lumbar pain, first of all, the site and nature of the pain should be clarified, and whether the pain is related to the spondylolisthesis should be judged, because degeneration of the disc adjacent to the spondylolisthesis site, small joint lesions or soft tissue It is because degeneration of the disc adjacent to the slipped disc, small joint lesions or soft tissue injuries can cause low back pain, and symptomatic treatment or experimental treatment, such as braking and physiotherapy, should be carried out to address the causes. If conservative treatment is ineffective or if it is determined that the pain is related to the slipped vertebrae, then surgery should be considered.3. The purpose of surgical treatment and surgical procedure for lumbar slipped vertebrae For patients with lumbar slipped vertebrae, an ideal surgery should include decompression of the compressed nerve tissue, reset of the slipped vertebrae, and fusion of the slipped vertebrae with the adjacent vertebrae. In patients with sciatica or intermittent claudication, decompression of one or both nerve roots is necessary. However, repositioning is generally not necessary for patients with mild slipped vertebrae, as long as the slipped vertebrae are fused and the normal physiological anterior convexity of the lumbar spine is maintained. With the development of biomechanics and surgical techniques in the field of spinal surgery, the surgical treatment of lumbar spondylolisthesis has received increasing attention. In the case of ineffective non-surgical treatment, the selection of a suitable case for lumbar fusion is currently the most reliable technique and the ultimate goal of surgery. At present, the main fusion methods used in clinical practice are posterior-lateral vertebral body graft fusion and intervertebral body graft fusion. What is intervertebral fusion? It is the placement of fusion material between two slipped vertebral bodies to fuse the two vertebral bodies into one, while postero-lateral fusion is the fusion of the posterior bony tissue (attachment) of the vertebral body into one, with instability still existing between the anterior vertebral bodies. A large body of biomechanical literature demonstrates that interbody fusion has more theoretical advantages than posterior posterolateral, and that the combined clinical application of an interbody fusion with an internal arch nailing system provides both immediate and permanent stability and is currently the preferred modality for the surgical treatment of lumbar spondylolisthesis.