Anterior and posterior spinal fusion. Staged versus same-day surgery.

Seventy-five patients who underwent combined anterior and posterior spinal fusion were compared to evaluate the results and safety of staged vs. continuous anterior and posterior spinal fusion. Thirty-five patients underwent two-stage anterior and posterior spinal fusion. The first stage consisted of anterior release; the second stage, which took place 7-10 days later, consisted of posterior spinal fusion and instrumentation. Forty patients underwent continuous anterior and posterior spinal fusion. This procedure consisted of anterior release followed by immediate posterior spinal fusion and instrumentation. The results show that 1) a continuous procedure is faster than the staged procedure; 2) there is less blood loss; 3) fewer days are spent in the hospital; and 4) better correction of the spinal deformity is achieved. Also, the complications were less frequent and less severe with the continuous procedure. It was concluded that the continuous procedure is safe and efficacious and has several advantages over the staged procedure.