High Grade Spondylolisthesis and Cauda Equina Syndrome A 43 year old female presented with Back pain with Both lower limb radiation since last 4 years. She also had urinary incontinence and constipation. Her MRI showed L5s1 high grade Spondylolisthesis with compression of Nerve roots. After due counselling , Patient underwent decompresion and fusion i.e TLIF. Her back and leg pain improved . Her walking and standing time also improved. There was partial improvement in bowel and bladder problems due to long standing nature of compression.