This volume provides a comprehensive review of the definition, biomechanics, physiopathology, clinical presentation, diagnosis, and treatment of lumbar segmental instability. Leading international experts shed new light on the controversies surrounding this condition and offer clinicians guidance in choosing appropriate and cost-effective therapy. Coverage includes discussions of the clinical definition and natural history of lumbar segmental instability and chapters on sciatica, central and lateral stenosis, and spinal instability due to metastatic cancer and iatrogenic conditions. The book offers guidelines on the use of MR imaging and other radiologic studies in the diagnostic workup. A section on conservative treatment examines rheumatologic approaches, exercise, and manipulation and thoroughly explains the rationale for lumbar orthoses. An extensive section on surgical treatment describes a variety of techniques, approaches, and devices for achieving elastic or rigid fixation. Also included are in-depth discussions of the ethical and economic implications of operating on this controversial pathology
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