ABSTRACT
Lumbar surgical operation is the crucial treatment against lumbar degenerative diseases (LDDs), whose development depends on persistent comprehension and innovation of vertebral biomechanics. The thorough understanding of biomechanical changes during lumbar senescence and degeneration is the important bedrock to grasp LDDs pathogenesis, renovate LDDs surgical strategy, and embrace more precise and minimally invasive treatment against LDDs. Herein, in this review, the intimate crosstalk between LDDs with degenerative biomechanics of vertebrae, intervertebral disc and paravertebral muscles was elucidated, followed by the classification of lumbar surgery history into non-vertebral implant era (before the year 1980), vertebral implant era (during the year 1980-1990), vertebral fusion era (during the year 1990-2010), precise and minimally invasive decompression era (after the year 2010) based on lumbar surgical characteristics in each era. The significance of representative biomechanical studies in each era for lumbar surgery was also concluded. From biomechanical perspectives, the history of spinal surgery is the development history of surgical strategies that has progressed as the continuously in-depth understanding of spinal biomechanics. With the deepening of spinal biomechanical researches, spinal surgeons are expected to develop treatment strategies that are more adapted to physiological and biomechanical characteristics of the spine, thereby guiding the future direction of spinal surgery advancement.