title: [Lumbar fusion in adults--dorsal or combined ventral/dorsal approach?].
abstract: 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.
authors.affiliation: Universitätsklinik fäur Orthopädie, Innsbruck.
authors.forename: M
authors.initials: M
authors.lastname: Krismer
authors.forename: T
authors.initials: T
authors.lastname: Auckenthaler
authors.forename: R
authors.initials: R
authors.lastname: Gruber
authors.forename: C
authors.initials: C
authors.lastname: Wimmer
authors.forename: W
authors.initials: W
authors.lastname: Sterzinger
authors.forename: M
authors.initials: M
authors.lastname: Ogon
mesh_terms: 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