title: Surgical options for lumbosacral fusion: biomechanical stability, advantage, disadvantage and affecting factors in selecting options.
abstract: OBJECTIVE
  Numerous surgical procedures and instrumentation techniques for lumbosacral fusion (LSF) have been developed. This is probably because of its high mechanical demand and unique anatomy. Surgical options include anterior column support (ACS) and posterior stabilization procedures. Biomechanical studies have been performed to verify the stability of those options. The options have their own advantage but also disadvantage aspects. This review article reports the surgical options for lumbosacral fusion, their biomechanical stability, advantages/disadvantages, and affecting factors in option selection.
  
  
  METHODS
  Review of literature.
  
  
  CONCLUSIONS
  LSF has lots of options both for ACS and posterior stabilization procedures. Combination of posterior stabilization procedures is an option. Furthermore, combinations of ACS and posterior stabilization procedures are other options. It is difficult to make a recommendation or treatment algorithm of LSF from the current literature. However, it is important to know all aspects of the options and decision-making of surgical options for LSF needs to be tailored for each patient, considering factors such as biomechanical stress and osteoporosis.
authors.affiliation: Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 301 East 17th St., New York, NY, 10003, USA, hiroyoshihara55@yahoo.co.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshihara
mesh_terms: D001696:Biomechanical Phenomena; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods; D004867:Equipment Design; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology; D065289:Pedicle Screws; D011829:Radiation Dosage; D011859:Radiography; D012446:Sacroiliac Joint / Q000601:surgery; D012447:Sacrum / Q000000981:diagnostic imaging / Q000601:surgery*; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*