Single-surgeon simultaneous versus staged anterior and posterior spinal reconstruction: a comparative study.
BACKGROUND
Complex three-column disease of the thoracic or thoracolumbar spine often requires anterior and posterior surgical approaches for complete decompression and reconstruction. Although this has traditionally been accomplished with staged procedures, recent reports describe treatment with simultaneous anterior-posterior procedures, typically utilizing two spinal surgical teams. This study compares the surgical treatment of 14 patients, all with three-column disease of the thoracic or thoracolumbar spine, treated at a single institution.


METHODS
Half were treated by the author with single-surgeon simultaneous anterior-posterior surgical reconstruction, whereas half were treated by another surgeon with staged anterior and posterior approaches. The indications, operative details, hospital course, neurologic outcome, complications, and degree of deformity correction were compared through prospective and retrospective analysis.


CONCLUSIONS
Single-surgeon simultaneous anterior-posterior reconstruction represents a safe and practical approach to the treatment of three-column complex pathology of the thoracic or thoracolumbar spine and may allow better correction of deformity than staged procedures.
Wright
Neill
N
Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA. wrightn@nsurg.wustle.edu
D000293:Adolescent; D000328:Adult; D015984:Causality; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000706:statistics & numerical data / Q000639:trends; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D019106:Postoperative Hemorrhage; D011446:Prospective Studies; D011859:Radiography; D012189:Retrospective Studies; D012907:Smoking / Q000639:trends; D013119:Spinal Cord Injuries / Q000209:etiology; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome