<s>[INST] Dear Doctor, I am suffering from spinal spondylolisthesis of lumbar L5 over S1 from last ten years but I was running fine. from 15days back I feel very painful and contact with doctors in our country Bangladesh. some of one said, it is going to static position, so you need not to go for surgery and other doctor said you go for surgery. It is so risky operation, may be successful otherwise your position will deteriorate. so,please give me suggestion what to do. Best regards. Monzur Elahi khan Dhaka Bangladesh [/INST] Dear Concur, If the pain is localized or with/without radiation to some extent then this can be managed conservatively with Physiotherapy including some electrotherapy modalities, pelvic traction, manual therapy, corrective exercises along with some nerve vitamin tablets..... One assistive devise such as "lumbosacral brace" will be for useful in this case.  Once pain is reduced you can join core strengthening classes only under a supervision of a certified physiotherapist who can design exercises specifically for you as per your condition..... If there is persisting weakness in your legs, increasing gradually and showing sluggish reflexes (Deep tendon reflexes) then this represents motor weakness, and you need to be ready for a surgical procedure.... Although this surgery is a risky and expensive one these days the latest technologies in an operation theater (OT) have already introduced to reduce the risk factors..... So wish you a good health soon..... </s>