Published online Jan 18, 2015. doi: 10.5312/wjo.v6.i1.117
Peer-review started: December 31, 2013
First decision: March 12, 2014
Revised: July 14, 2014
Accepted: July 27, 2014
Article in press: July 29, 2014
Published online: January 18, 2015
Core tip: Not restoring the adequate lumbar lordosis during fusion surgery may result in mechanical pain, sagittal unbalance and adjacent segment degeneration. The objective of this paper is to describe the current strategies and concepts for restoration of adequate lordosis during fusion surgery. The amount of lordosis to restore can be precisely evaluated from the analysis of spino-pelvic parameters. Technical tools during surgery involve patient positioning, release maneuvers, type of instrumentation used and surgical sequence. Finally, not one but several strategies may be used to restore the adequate lordosis during fusion surgery.