Posterior lumbosacral fusion using bone graft without internal fixation requires long immobilization and has high rate of pseudoarthrosis. To overcome such limitation technique of spinal internal fixation has been developed and applied in past twenty years. Since 1982, the authors have done lumbosacral fusion with internal fixation and bone graft by using Harrington alar hook (32 cases), luque ring (26 cases), Galveston technique (7 cases), Steffee plate (10 cases), Dick pedicle screw (1 cases), RF instrumentation (3 cases) and CD technique (4 cases). Totally 83 cases have been treated, which include paralytic pelvic tilt (9 cases), spinal fracture (4 cases), lumbosacral tuberculosis (5 cases), degenerative stenosis (21 cases); L5-S1 spondylolisthesis (38 cases), L5-S1 disc protrusion (4 cases); L5 semivertebra (1 cases) and neurofibromatosis (1 cases). Patients have been follow-up for 63.7 months on average. Good fusion has been seen in 82 cases (98.8%). The procedure does not need long immobilization and has less complication.