Dilemma of Approaches to Thoracic and Lumbar Spine: Our 10 Years' Review

Background Lesions of the thoracic and lumbar spine are numerous. These lesions affect one or more columns (anterior, middle, and posterior) of the spine and compress the spinal cord either from anterior or posterior, giving rise to the features of radiculomyelopathy. These lesions can be approached either from the anterior or posterior aspect of the spine. We present our past 10 years' experience regarding the comparison between the two approaches. Methods Retrospective analysis of records of all patients with thoracic and lumbar lesion treated in our hospital between January 2005 and June 2014 was performed. Over the past 10 years, we came across 186 patients of thoracic and lumbar lesion who were operated either by anterior or posterior approach and were the focus of this study. Follow-up ranged from 6 months to 7 years. Results All the patients presented with neurological deficits. They were evaluated with investigation protocol of our hospital. Anterior approach was done in 38 cases (n = 38), and posterior approach was done in 148 cases (n = 148). We compared between the two groups in terms of perioperative complications, recovery, persisting symptoms, and mortality. Conclusion Complete recovery is better in the posterior approach (74.3 vs. 52.6%) and morality is more in the anterior approach (7.9 vs. 1.3%).