(iv) Lumbar stabilisation techniques

SummaryChronic lower back pain due to degeneration of the lumbar spine, commonly referred to as mechanical back pain, is thought to be due to instability of the lumbar motion segment that is secondary to disc degeneration and facet arthrosis. This article concentrates on the various types of stabilisation techniques used to treat such disorders. Traditionally, fusion has been the mainstay of treatment. Many techniques have been developed to maximise fusion rates but a corresponding improvement in clinical outcomes has not been seen. Motion sparing techniques such as dynamic stabilisation, total disc replacement and nucleus pulposus replacement, are alternative forms of treatment. Such new technologies are predicted to have a big impact on the treatment of lumbar instability but as yet require more development and clinical trials.