Abstract: Objective To observe middle and long-term clinical efficacy of modified transforaminal lumbar interbody fusion(TLIF)in the treatment of lumbar spondylolisthesis. Methods The clinical data of 38 patients with single segmental lumbar spondylolisthesis treated by modified TLIF was retrospectively analyzed. Duration of surgery, intraoperative blood loss, risk of intraoperative dural sac and nerve root injury, postoperative reduction and middle and long-term lumbar fusion were observed. The clinical efficacy was evaluated by Visual Analogue Scale(VAS)score and Japanese Orthopedics Association(JOA)score before operation, at one month and one year after surgery and at the time point of final follow-up(3 years and above after operation). Results All the 38 patients successfully completed the surgeries, without nerve root and dural sac injury. Average operative time was(157.1±35.7)min, and average intraoperative blood loss was(318.5±76.7)mL. All patients were followed up for 3 to 7 years, with an average of 4.7 years. VAS score of postoperative lumbar and leg pain was lower, and JOA score was significantly higher than that before operation, and the differences were statistically significant(P<0.05). All the 38 patients with spondylolisthesis had good reduction and bone fusion. Conclusion The modified TLIF operation for lumbar spondylolisthesis can effectively reduce the risk of dural sac and nerve root injury, and has the advantages of shorter operation time, less bleeding and good reduction.