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To Fuse or Not to Fuse: That’s the Question

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Advanced Concepts in Lumbar Degenerative Disk Disease

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Abstract

Over the last few decades, significant advances have been made with regard to fusion technologies in the lumbar spine. The advent of pedicle screw fixation, lateral interbody grafting techniques, recombinant human bone morphogenetic proteins, and minimally invasive surgical approaches has resulted in a significant increase in the number of fusion procedures annually. As an aging, active population continues to expand, more patients seek appropriate therapies to alleviate pain, restore function, and maintain their active lifestyles. While the technologies and techniques available to the spine surgeon have improved and expanded, the debate continues over the appropriate indications for fusion in the setting of lumbar degenerative disc disease. The purpose of this chapter is to review current evidence for lumbar spinal fusion procedures and provide recommendations for evaluation, clinical workup, and surgical decision making in this challenging patient population.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA, 92134-5000, USA

    Ryan P. Ponton MD & Eric B. Harris MD

  2. Professor of Orthopaedic Surgery at Jefferson Medical College, Director of Orthopaedic Medical Education, Professor of Neurosurgery at Jefferson Medical College, 25 Chestnut Street 5th Floor, Philadelphia, PA, 19107, USA

    Alan Hilibrand MD

Authors
  1. Ryan P. Ponton MD
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  2. Eric B. Harris MD
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  3. Alan Hilibrand MD
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Corresponding author

Correspondence to Eric B. Harris MD .

Editor information

Editors and Affiliations

  1. Neurological and Spine Surgery, Hospital Samaritano, São Paulo, São Paulo, Brazil

    João Luiz Pinheiro-Franco

  2. Rothman Institute, Thomas Jefferson University Medical Center, Philadelphia, Pennsylvania, USA

    Alexander R. Vaccaro

  3. Cleveland Clinic Neurological Surgery, Cleveland, Ohio, USA

    Edward C. Benzel

  4. Schön Klinik München Harlaching FG Wirbelsäulenchirurgie, München, Germany

    H. Michael Mayer

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© 2016 Springer-Verlag Berlin Heidelberg

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Ponton, R.P., Harris, E.B., Hilibrand, A. (2016). To Fuse or Not to Fuse: That’s the Question. In: Pinheiro-Franco, J., Vaccaro, A., Benzel, E., Mayer, H. (eds) Advanced Concepts in Lumbar Degenerative Disk Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47756-4_21

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  • DOI: https://doi.org/10.1007/978-3-662-47756-4_21

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-47755-7

  • Online ISBN: 978-3-662-47756-4

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