Indications for lumbosacral fusion.

In cases in which operation is indicated, the author advocates routine fusion of the lumbosacral joint in all cases of protrusion of the 5th lumbar disc, providing the spine above that level is considered essentially normal.He would do spinal fusion in all cases-provided operation were indicated-in which the primary complaint was that of low back pain and in which sciatic pain was absent or minimal. In such cases, the fusion area should extend as far as necessary to include the portion of the spine involved in pathologic change. Only in exceptional cases would spinal fusion be done in patients more than 50 years of age. With the exceptions noted, all patients requiring reoperation should have the benefits of lumbosacral fusion.