Lumbar spondylolisthesis - Spine surgery in Elderly patient A 80 year old male presented to us with severe back pain and left buttock pain for 1 month. He was not able to sit due to severity of pain. His MRI showed severe osteoporosis with L5 S1 spondylolisthesis. He underwent Lumbar decompression and pedicle screw fixation. His pain improved significantly and was discharged after three days Spine surgery in elderly is safe but needs strict post operative monitoring.