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Front to Back Comparison of Spine Fusion

Over the years doctors have tried different ways to fuse the lumbar spine. Interbody fusion has been done off and on without success, until recently. Now cages, commonly made of titanium, are placed between the vertebral bones. These devices help restore the disc space. They also take the pressure off the bone graft that is used to fuse the spine, improving the chances that the graft will heal.

The cages can be inserted from the front of the spine (anterior approach) or from the back of the spine (posterior approach). Which is better? That's the topic of this study. Doctors at the UCLA School of Medicine compared patients getting anterior lumbar interbody fusion (ALIF) cages to patients receiving posterior lumbar interbody fusion (PLIF) cages.

The authors used type and rate of complications as the measuring stick. They found the risk of complications during and after the operation is much higher for the PLIF group. In this study, major problems tended to be more likely in the PLIF group. Minor problems occurred more often in the ALIF group. The PLIF operation takes longer, and there's more blood loss with the posterior approach.

References: Anthony A. Scaduto, et al. Perioperative Complications of Threaded Cylindrical Lumbar Interbody Fusion Devices: Anterior Versus Posterior Approach. In Journal of Spinal Disorders. December 2003. Vol. 16. No. 6. Pp. 502-507.

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