A traditional teaching in orthopaedic surgery has been that, in cases of fusion for L4-5 dlscopathy or instability, one must include the lumbosacral joint. There is nothing in the literature to support this time-honored dictum. The senior author, among others, has rejected this concept; and, the authors are, therefore, in a position to present a 32-year experience with segmental or ldquo;floatingrdquo; fusion. Two hundred six floating fusions were performed, of which 184 were available for follow-up. Of these, 83.7percnt; achieved ldquo;Excellentrdquo; or ldquo;Goodrdquo; results; 15.2percnt; were rated ldquo;Fairrdquo;; and 2percnt; were rated ldquo;Poor.rdquo; Only five patients (2.7percnt;) had subsequent disc herniation at the lumbosacral level necessitating discectomy and extension of fusion to incorporate the sacrum.
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