This volume describes and demonstrates the most advanced techniques for lumbosacral and spinopelvic fusion with and without internal fixation. It thoroughly reviews the anatomy and biomechanics of the spine, offers guidelines for choosing those patients who will benefit from surgical fusion, and discusses the surgical management of spinal diseases that respond well to fusion with or without instrumentation.Most of the leading surgical techniques are discussed and compared, including new techniques using pedicle screws. Each approach and implant system is presented either by its developer or by a recognized expert in the technique. Coverage includes a section on problematic issues such as iatrogenic flat back, the decompensated spine, fusion in osteoporosis, and how to fuse an existing fusion mass to the pelvis. Also included are chapters on imaging, discography, rehabilitation, and future approaches such as artificial discs and artificial ligaments. More than 1,200 illustrations complement the text throughout.