Neill Wright1. 1. Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA. wrightn@nsurg.wustle.edu
Abstract
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.
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.
Authors: Peter G Passias; Yan Ma; Ya Lin Chiu; Madhu Mazumdar; Federico P Girardi; Stavros G Memtsoudis Journal: Spine (Phila Pa 1976) Date: 2012-02-01 Impact factor: 3.468