Low back pain is a very common problem. It has become one of the leading causes of disability, and the cost of treatment has been increasing progressively each year. On the other hand, the clinical results are not satisfactory. The search for a cure and elimination of back pain does not appear to be a viable option at this point. There are numerous theories trying to explain how the pain occurs. The segmental instability is an important factor in low back pain. The development of disk degeneration demolishes many pathologies starting from the simple annular tear to degenerative scoliosis. Simple discectomy, fusion, or total disc arthroplasty, all of these treatments, are based on the destruction/removal of lumbar disc. We must keep in our minds that none of any artificial material is now worth of our own disc. So our treatment strategy should always have a respectful strategy to disc. Pedicle screw-based dynamic stabilization urges us not to destroy/remove but support the functional segment.

On the other hand, multilevel chronic instability is predominantly seen in older age group. Fusion results are mostly disappointing, and total disc replacement has no place in the treatment of elderly patients.

We should conclude that either the dynamic stabilization is a strong alternative to traditional surgical methods, or fusion is still a gold standard in the surgical treatment of degenerative disc disease. Potential topics include, but are not limited to:

• Philosophy of pedicle screw-based dynamic stabilization
• Biomechanics of different systems
• Finite element studies
• Artificial ligament systems
• Dynamic rod systems
• Facet replacement systems
• Clinical series
• Superiority and weakest points of these systems
• Comparing with a fusion and disc prosthesis
• Complications

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