First of all, from the description of lumbar X-ray film, it belongs to true lumbar spondylolisthesis. The so-called true lumbar spondylolisthesis refers to lumbar spondylolisthesis caused by isthmus fissure, which used to be more common. It should be noted that if X-ray photos suggest lumbar spondylolisthesis, for the sake of safety, it is best to do local lumbar CT plain scan and three-dimensional reconstruction to see whether there is spondylolisthesis and the type of spondylolisthesis, because this is very important for the choice of treatment methods.

Lumbar spondylolisthesis, is it necessary to have an operation? Not necessarily, it depends on the type and degree of slippage, the symptoms and signs of the patient and many other aspects. Generally speaking, surgery is needed in the following situations:

(1). Lumbar spondylolisthesis below the second degree, intractable low back pain, or the original symptoms of low back pain are aggravated, which is ineffective after regular conservative treatment, seriously affecting the life and work of patients;

(2) Accompanied by lumbar disc herniation or lumbar spinal canal stenosis, lower extremity nerve root radiation pain and intermittent claudication, or cauda equina nerve compression symptoms;

(3) The course of disease is long, and it tends to get worse gradually;

(4) Severe lumbar spondylolisthesis with degree Ⅲ or above.

For this kind of patient, I think we can take conservative treatment first, including bed rest, back muscle exercise, wearing waist circumference or braces; You can do proper aerobic exercise to lose weight; It is forbidden to carry out activities such as lifting heavy objects and bending over to increase waist weight; In addition, it can be combined with physical therapy such as infrared ray and hyperthermia. If you have pain and other symptoms, you can take celebrex, Fenbid and other oral anti-inflammatory painkillers for symptomatic treatment. Of course, the above treatment needs the guidance of orthopedic doctors, and then re-check as required to see if the degree of slippage is aggravated. If there is an aggravating trend or the patient's symptoms worsen, surgery can also be considered.