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Up Front about Approaches for Spinal Fusion

Surgery to fuse the spine is a well-known treatment for severe low back pain that just won't go away. This surgery is done most often when the patient has changes in the discs such as thinning and tears, commonly called degenerative disc disease.

There are many studies comparing types of fusion and results of fusion. One important question is whether to approach the disc from the front or back of the body. There are so many factors to consider, it's somewhat like comparing apples to oranges.

A new study compares fusion at one level when done from the front (anterior approach) versus the back (posterior approach). A single-level procedure fuses two vertebrae together. This type of spinal fusion is simpler than multi-level fusions. There are fewer problems during or after the operation.

According to this study, the anterior approach was the better choice for many reasons. There was less blood loss and less need for blood transfusion. The surgery time was shorter and the stay in the hospital was also shorter. Patients who had the anterior fusion had less need for transitional care after leaving the hospital.

In some cases, the patient's condition requires one method over the other. This may be the case when there are many spinal levels involved. The posterior method may be used when there is a deformity that must be corrected. The anterior approach is best when a single level must be fused and there are no other problems present.

References: Ben B. Pradham, et al. Single-Level Lumbar Spine Fusion: A Comparison of Anterior and Posterior Approaches. In Journal of Spinal Disorders. October 2002. Vol. 15. No. 5. Pp. 355-361.

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