[Lumbar fusion in adults--dorsal or combined ventral/dorsal approach?].
A retrospective study was conducted to compare the results of posterior with combined anterior/posterior lumbar fusion in adults. Seventy-six consecutive posterior cases fused with pedicle screws and 46 combined cases were included and followed for at least 2 years. Subjective assessment was based on the Visual Analogue Scales, Waddel Disability and Impairment Score and the GBB for objective quantification of complaints. Furthermore, a thorough clinical examination was done and X-rays including flexion/ extension radiographs, were taken. Questions were asked about the occupational status as well. Pain decreased significantly more in the combined cases than in the posterior fusion cases. In one case a lesion of the common iliac vein occurred during a retroperitoneal approach. Only about half the patients working preoperatively returned to work again. In conclusion, the benefit of better pain relief after combined fusion must be regarded in relation to a higher complication rate due to a second approach.
Krismer
M
M
Universitätsklinik fäur Orthopädie, Innsbruck.
Auckenthaler
T
T
Gruber
R
R
Wimmer
C
C
Sterzinger
W
W
Ogon
M
M
D000328:Adult; D000368:Aged; D001863:Bone Screws; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013169:Spondylolysis / Q000601:surgery*; D016896:Treatment Outcome