Surgical treatment for the painful motion segment - Matching technology with the indications: Posterior lumbar fusion

Study Design. A convenience literature-based review of the different techniques of posterior lumbar fusion. Objective. To describe the history, specific techniques, and outcomes of different methods of posterior lumbar fusion. The specific methods that were described include 1) uninstrumented posterior, posterolateral, and facet fusion, and 2) instrumented fusion using pedicle screws or facet screws. Summary of Background Data. There are various posterior fusion techniques available for the treatment of degenerative lumbar spine conditions. Each individual technique has specific technical demands, indications, advantages, and disadvantages which should be taken into consideration when performing these procedures. Methods. The published scientific literature on the different methods of posterior lumbar fusion was reviewed. The history, indications, advantages, disadvantages, and clinical and radiographic outcomes were described based on the literature search. Results/Conclusions. Posterior fusion techniques have been and will continue to be among the most commonly performed procedures in lumbar spine surgery. The different methods of fusion are well defined, as are the possible complications and outcomes. They are effective techniques when performed on appropriately selected patients by a surgeon knowledgeable in the techniques and indications. Further studies are needed regarding promising but relatively unproven developments such as minimally invasive surgery and the use of osteoinductive agents.