There are significant disparities in the integration of fusion operations in spine surgery practices in the USA. Increased intensity of neurosurgical care was associated with a higher fusion rate 1).

The objective of lumbar spine fixation surgery is to stop motion at a painful spine segment, minimizing the pain and allowing the patients to increase their function 2) 3) 4).

Since the first successful fusion procedures in 1911 for the Pott disease, spinal surgical fixation devices have enhanced tremendous advancements in spinal surgeries with strong evidences showing that instrumented fusion produced a higher rate of fusion 5) 6) 7).

1)
Bekelis K, Missios S. The association of regional intensity of neurosurgical care with spinal fusion surgery in the USA. Eur Spine J. 2014 Apr;23(4):909-15. doi: 10.1007/s00586-014-3201-6. Epub 2014 Feb 4. PubMed PMID: 24492948; PubMed Central PMCID: PMC3960423.
2)
Bennett GJ, Serhan HA, Sorini PM, Willis BH. An experimental study of lumbar destabilization. Restabilization and bone density. Spine (Phila Pa 1976) 1997;22:1448–1453.
3)
Esses SI, Sachs BL, Dreyzin V. Complications associated with the technique of pedicle screw fixation. A selected survey of ABS members. Spine (Phila Pa 1976) 1993;18:2231–2238.
4)
Schnee CL, Freese A, Ansell LV. Outcome analysis for adults with spondylolisthesis treated with posterolateral fusion and transpedicular screw fixation. J Neurosurg. 1997;86:56–63.
5)
Hibbs RA. An operation for progressive spinal deformities: a preliminary report of three cases from the service of the orthopaedic hospital. 1911. Clin Orthop Relat Res 2007;460:17–20.
6)
Albee FH. Transplantation of a portion of the tibia into the spine for Pott's disease: a preliminary report 1911. Clin Orthop Relat Res 2007;460:14–16.
7)
Gibson JN, Grant IC, Waddell G. The Cochrane review of surgery for lumbar disc prolapse and degenerative lumbar spondylosis. Spine (Phila Pa 1976) 1999;24:1820–1832.