Simultaneous combined anterior and posterior fusion. An independent analysis of a treatment for the disabled low-back pain patient.
Sixty-nine patients were treated by a simultaneous combined anterior and posterior fusion for disabling low-back pain as directed by discographic pain provocation. They were evaluated independently, with an average follow-up of 2 1/2 years (range, 1.6 to 4.1 years). Fusion rates in excess of 90% were noted in patients who had undergone one- and two-level fusions, whereas the fusion rate for three-level procedures dropped to 77.8%. Acceptable clinical results were seen in approximately 80% of the primary low-back pain and the postlaminectomy patients. Results within the group of patients who had undergone previous fusion procedures were less favorable: two thirds good or fair. The available evidence suggests that this procedure is a valid surgical technique, especially applicable to multilevel lumbar fusions and the postlaminectomy patient. Despite its seemingly radical nature, it can be performed quickly and safely with adequate surgical training.
Kozak
J A
JA
London Clinic, England.
O'Brien
J P
JP
D000328:Adult; D001416:Back Pain / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*; D013997:Time Factors