Lumbo-sacral interbody spinal fusion.

During the years from 1948 to 1956 a lumbo-sacral inter-body spinal fusion was done on forty-eight patients through a posterior approach. The operations have been divided chronologically into three groups. Improvements in the surgical technique were added in the two later groups, so that ultimately a new operative procedure was evolved and used in the last group, which gave the highest rate of bony fusion. In this new operation the lumbo-sacral intervertebral disc is approached through the lateral mass of the sacrum, which gives a good exposure through which to perform the inter-body fusion. It must be emphasised that this operation was developed not only from the personal experience of the author but also from reports and advice from other workers such as James and Nisbet (1953), Cloward (1953), du Toit (1955), du Toit, Dommisse and Muller (1956) and du Toit (1957).