Which approach to the spine is better and why? Anterior vs. Posterior

**xiaoyu80305** · 05-20-2011, 11:55 AM

Originally Posted by Justin

Either approach is appropriate and one may be preferred based on your pathology. Both procedures have pros and cons.

The anterior approach inherently carries more of a risk, as the great vessels (inferior vena cava and abdominal aorta) must be mobilized to expose the higher lumbar levels (L5/S1 occurs just below the bifurcation of the great vessels [or where the great vessels split into the common iliac arteries and veins]). Mobilization means retracting, or moving, the great vessels to the side of the vertebral bodies; thus, exposing the intervertebral discs.

The posterior approach to the spine can often involve a lot of muscle stripping and insult to many posterior stabilizing structures.

I just did a quick search, and this is a great read: Anterior Approach for the Treatment of Lumbar Degenerative Disorders: Axial Back Pain.

Good article! very educational. Thanks, BTW, Thank you for modifying the title of my thread, which would make more sense.

**akillas** · 05-20-2011, 03:02 PM

There is also the lateral approach to consider but i believe that the surgeons u got advise from are familiar with all the techniques and most probably they choose the one that is more appropiate for your condition.

**Justin** · 05-20-2011, 04:08 PM

Originally Posted by xiaoyu80305

Good article! very educational. Thanks, BTW, Thank you for modifying the title of my thread, which would make more sense.

No problem on the article. I usually update thread titles so that others can more easily find what they are looking for either by the search function or by scrolling down a given Forum.

**xiaoyu80305** · 05-20-2011, 05:37 PM

Originally Posted by akillas

There is also the lateral approach to consider but i believe that the surgeons u got advise from are familiar with all the techniques and most probably they choose the one that is more appropiate for your condition.

Can you give me more information about this lateral approach? Thanks,

**JRS11** · 03-25-2012, 12:03 PM

This thread is timely. My first back surgery in June of '11 has not relieved my pain and the neuropathy I feel still goes away when I lie down. Since surgery I have been worse as far as standing and walking (cannot for more than a short period of time without horrible pain. So I have started talking to Neuro-Surgeons. A different surgeon (2 opinions so far not very different). First was to fuse L5/S1, the other is that and rods and screws (maybe the first surgeon never got into it thoroughly). The second surgeon recommended going in from the back. If this is done, if there is any disk material left how do they clean out the front, this is on things I do not know. Time will tell for me, I have 2 more appts set up with different providers and am thinking of going into Boston but I have no names.

if anyone has any thoughts on this I would really appreciate hearing them.

Joel