title: Comparison of same-day sequential anterior and posterior spinal fusion with delayed two-stage anterior and posterior spinal fusion.
abstract: METHODS
  This was a retrospective review. Short-term outcomes were compared based on two different surgical techniques.
  
  
  OBJECTIVE
  To determine the safety, efficacy, and cost effectiveness of two different surgical techniques of anterior and posterior spinal fusion for pediatric patients with spinal deformity.
  
  
  BACKGROUND
  Brown et al, Floman et al, and Bradford et al have reported on combined anterior and posterior spine fusions with a 1-2-week recovery period between stages. However, advances in surgical and anesthetic techniques combined with the prohibitive cost of prolonged hospitalization and theoretical advantages in pulmonary function and nutrition have led to increasing use of combined anterior and posterior spinal fusion under one anesthetic.
  
  
  METHODS
  The authors reviewed records and radiographs of patients with pediatric spinal deformities who underwent anterior spine fusion/posterior spine fusion and instrumentation performed by the senior author (HAK) at one institution.
  
  
  RESULTS
  Same-day sequential anterior spine fusion/posterior spine fusion resulted in less blood loss (575 +/- 275 ml; P < or = 0.0045), shorter hospital stay (8.00 +/- 2.68 days; P < or = 0.0001), and reduced hospital costs ($18,762 +/- $4,925; P < or = 0.0001). Operative time and complication rate were not affected.
  
  
  CONCLUSIONS
  In selected patients with pediatric spinal deformity, experienced spinal surgeons can reduce blood loss, hospital stay, and costs by performing anterior and posterior spinal fusions sequentially under one anesthetic.
authors.affiliation: Children's Hospital and Medical Center, Seattle, Washington.
authors.forename: E T
authors.initials: ET
authors.lastname: Powell
authors.forename: W F
authors.initials: WF
authors.lastname: Krengel
authors.forename: H A
authors.initials: HA
authors.lastname: King
authors.forename: M O
authors.initials: MO
authors.lastname: Lagrone
mesh_terms: D000293:Adolescent; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002648:Child; D005260:Female; D017721:Hospital Costs; D006801:Humans; D016268:Internal Fixators; D007738:Kyphosis / Q000453:epidemiology / Q000601:surgery*; D007902:Length of Stay / Q000191:economics; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012600:Scoliosis / Q000453:epidemiology / Q000601:surgery*; D013123:Spinal Fusion / Q000191:economics / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome