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A male sufferer,46 years old,having a backache after weariness from overwork, sport, obstacle of the movement, being gradually aggravating intermittent lame for three years.When the conservative therapy such as traction,massage and Chinese traditional medicine had no obviously effect ,he determined to go to the hospital to get a check. After the check by X-ray in our hospital we found that the fourth lumbar vertebra bow gorge department fracture , the lumbar vertebra spondylolisthesis between the fourth and fifth waist vertebras ,Meyerdig I?so the doctor got the diagnosis that the fourth lumbar vertebra spondylolisthesis. From the clinic exhibition we got the conclusion that the patient would need a surgery operation to loose the being oppressive nerves and rebuild the stability of the lumbar vertebras.After a openning reduction and fixing with the internal spinal skeletal fixation ,taking the vascularized ilium flap transplantation with the pedicel of the third waist artery into the interspace of the third and fifth lumbar transverse process for fusion,the patient got back with the disappear of the lumbar paining and acquire a satisfying resume of the lumbar vertebra function.From this case we could discuss the diagnosis and therapy of the lumbar vertebra spondylolisthesis at first ,the second we could learn the development of the lots of internal spinal skeletal fixations and compare their respective characteristics,the third we can discuss the difference of the vascularized bone transplantation.and the traditional bone transplantation.