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Posterior fusion or Anterior+Posterior fusion?

hello- I have to get a T9-pelvis fusion. I have a 75 degree Scurve and 55-60 degree kyphosis. Degenerative DD, stenosis etc. I’ve had several consults and some recommend the ant/post approach whereas another just recommends the posterior approach.  All my consults are top docs in the Philly or NY area. 

What have you done? 

If posterior only- how have you faired? Any additional surgeries you have had to get done since the posterior one? 

Thanks so much! 



  • Welcome kbswimwm - I have a T9 - S1 fusion w/ pelvic fixation for adult onset idiopathic lumbar scoliosis.  I had an anterior and posterior approach performed 2 days apart - 6 hours per surgery.  This is the way my surgeon does these surgeries to reduce the length of general anesthesia at one time and also (I think) for better access for disc removal and cage insertion.  I don't think having 3 surgical sites when I left the hospital affected me any different than if I would have gone home with just one incision on my back.  You should have a dialogue with the surgeons about their procedures and why they prefer one approach over the other.  It may be something specific to your situation or maybe just what they feel comfortable and adept at.  Good luck with your decision.

    10 level fusion T9 - S1 with pelvic fixation. Two titanium rods, 24 screws, 4 cages.

    Firm believer in PMA

  • WLLadyWLLady Ontario CanadaPosts: 1,486

    i have T10 - S2 and pelvis by posterior approach only for scoliosis, 3 laminectomies, facet joint removals for severe degenerative facet arthritis and 2 discs replaced.  because of the posterior only approach i had my surgery in 1 10 hour day, and they could not get 2 cages into one of my disc spaces (hence 3 cages instead of 4).  With that said, i think my recovery has been good...but i did not need any anterior stabilization of my spine (i had 2 fractured vertebrae as well) and because they went to S2 and pelvis they didn't need to go anteriorly for me. 

    i do not know if there's any benefit vs not to multiple approach or not, just that my surgery seems to have worked, everything stayed put where it was supposed to.  likely an anterior approach makes it easier for cage insertion, but i haven't had any any issues with "missing" a cage at L5-S1....

    Veritas-Health Moderator
    Dec '16 T10-S2 fusion with pelvic fixation. Laminectomies L2, L3, L4, L5, facet removal, cages L4-5, L5-S1, severe scoliosis, arthritis and stenosis repair. 

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  • memerainboltmemerainbolt IndianaPosts: 6,366

    hello kbswimwm
    welcome to spine-health

    i agree with urbmshr's suggestion for you to have a discussion with your surgeons about the different procedures and why they suggest them. below is a link that may help you ask those questions.
    40 questions to ask your surgeon

    please also click on the welcome link below and tutorial to get you started on the forum.
    welcome to spine health

    Veritas-Health Forum Moderator
    Please read my  Medical History
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