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An understanding of the biomechanics of spinal instruments is essential to the proper use of these instruments. The biomechanics of commonly used as well as newly described cervical and thoracolumbar spinal instrumentation is reviewed. In the cervical spine, emphasis is placed on traditional approaches, because they still offer the safest and most effective method of stabilization. Because newer techniques have substantially replaced traditional methods in the thoracolumbar spine, emphasis is placed on these newer methods. This article discusses the potential risks and benefits of each instrumentation system.