Abstract
Spinal instability forms the basis of spinal degeneration. Muscle weakness related to their disuse,
abuse or injury initiates and later propels the process of degeneration. All the known and socalled ‘pathological’ processes like osteophyte formation, disc space reduction, buckling of intervertebral ligaments are secondary processes and are possibly natural protective in nature and are
reversible after spinal stability is restored. It is not compression or deformation of neural structures
but it is segmental spinal instability that causes symptoms in spinal degeneration. Identification
of unstable spinal segments and their stabilization and aiming for arthrodesis forms the basis of
surgical treatment. Decompression of neural structures by resection of bones and soft tissues can
have negative connotation in the treatment.