Abstract

The reason for inadequate results after the treatment of spinal lesions may be due to the misinterpretation of the type of lesion thus leading to incorrect therapy. Frequently the biofunctional construction principles of the spine are ignored and biomechanically based reconstruction of the spine is not done. Unsuitable approaches and fusion techniques may result in insufficient stabilisation with predictable failure. In both the first surgery and the salvage procedure, the principles of the load-sharing system as well as the posterior tension band principle must be respected. These principles and the surgery techniques are demonstrated in individual examples. Special attention is drawn to the impact of segmental deformities on the general statics of the spine. Frequently, residual deformities with the typical clinical picture lead to decompensation and the reduction of efficiency only after ten to fifteen years.

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