JPOSNA Masters Surgical Technique: Lumbar spondylolisthesis in adolescents is a common cause of back pain. Low-grade spondylolisthesis usually responds to non-surgical treatment. High-grade spondylolisthesis often requires surgery for relief of symptoms. The primary goals in surgical treatment of adolescent lumbar spondylolisthesis (L5-S1) are relief of back and radicular pain, relief of any motor weakness from nerve compression, and achieving a stable spinal fusion. Optimal surgical strategy is debated with questions regarding need for reduction of deformity, choice of spinal instrumentation, use of interbody fusion, and choice of bone graft.