Objective To introduce the surgical techniques and preliminary clinical results of lumbar spondylolysis treated by posterior lumbar nail hook rod fixation, isthmus freshening and autogenous iliac bone graft. Methods: From March 2014 to October 2018, 20 patients with bilateral spondylolysis of the lumbar spine were treated by "nail-hook-rod" fixation combined with isthmic bone graft. Expose spondylolysis vertebral body lamina and isthmus. The nucleus pulposus forceps were used to remove the fibrous tissue in the isthmus, and the sclerotic bone in the isthmus was cleaned by grinding and drilling until bleeding. The vertebral pedicle screws were implanted on both sides of the spondylolysis vertebral body, and the lamina hooks were connected by connecting rods. The isthmus was naturally closed reduction when the nut was locked. Then, the iliac bone from the body was grafted at the spondylolysis site and compacted.Results All patients were successfully operated without serious complications during the operation. At the last follow-up, VAS score was（1.25±0.44）,ODI score was （3.95±0.99）, and JOA score was（24.40±2.11）, all of which were significantly improved compared with those before surgery (P < 0.05). The mean time of bone fusion was （9.70±1.92 ）months. 19 case had bone healing, and the bone fusion rate was 95.00%. Conclusion Posteriolumbar nail hook rod fixation, isthmus freshening and autogenous iliac bone graft are safe and effective surgical methods for lumbar spondylolysis.