J Am Acad Orthop Surg, Vol 18, No 10, October 2010 Michael J. Lee, MD, Joshua D. Lindsey, MD and Richard J. Bransford, MD
Traditionally, management of spinal pathology has centered on decompression, correction of deformity, and stabilization. Deformity correction and stabilization have been accomplished largely by spinal fusion at the pathologic levels. In addition to the risks and potential complications, there are sequelae to a successful fusion. Therefore, attention is being directed toward disk replacement in the lumbar spine. In addition to their preserving motion in the anterior column, several posterior motionpreservation devices have been developed in an effort to prevent pathologic motion at both a decompressed level and a segment adjacent to a fusion. Initial studies suggest that the results of posterior dynamic stabilization may be comparable to those of fusion; however, longer periods of clinical and radiographic follow-up are required to fully define the role these devices may play in the management of the degenerative lumbar spine.