title: Refinements to the simultaneous anterior-posterior approach to the thoracolumbar spine.
abstract: The treatment of complex thoracolumbar disorders occasionally requires combined anterior and posterior approaches. Traditionally, these are either sequentially staged to occur during the same anesthesia procedure or alternatively performed on separate days. A less common option is the simultaneous anterior-posterior approach. The authors discuss the rationale for this approach in selected cases and illustrate a number of modifications to previous descriptions of the procedure. By slightly altering the incision, the risk of wound breakdown and infection has been reduced. The use of newly available positioning devices has allowed easy incorporation of fluoroscopy to guide the placement of spinal instrumentation. The authors have also expanded the use of the approach beyond the original oncological indications to include trauma and infection.
authors.affiliation: Division of Neurosurgery, Royal University Hospital, University of Saskatchewan, Saskatchewan, Canada.
authors.forename: Lissa
authors.initials: L
authors.lastname: Peeling
authors.forename: Evan
authors.initials: E
authors.lastname: Frangou
authors.forename: Stephen
authors.initials: S
authors.lastname: Hentschel
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
authors.forename: Daryl R
authors.initials: DR
authors.lastname: Fourney
mesh_terms: D000328:Adult; D015299:Discitis / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D010019:Osteomyelitis / Q000601:surgery; D013122:Spinal Diseases / Q000601:surgery; D013904:Thoracic Vertebrae / Q000601:surgery*