A Different Approach to Posterior Spinal Instrumentation

Agha S. Khan, MD, FACS
Carol Jerosimicb, PA (Baltimore, MD)

Introduction:

The posterior lumbar spinal paramedian approach has had similar or better results than the conventional approach with easier exposure, less tissue damage, decreased morbidity, and less blood loss, Of the 150 patients surveyed, 55% females and 45% males, ranging in age from 30's to 60's, and in various states of health. Most cases underwent fusion secondary to advanced degenerative disc disease, others resulted from other medical problems.

Method:

A questionnaire was mailed, with follow up by mail, telephone, and during post operative office visits, consisted of patient's perception of the amount of relief achieved from symptoms, increase in function, and ability to perform their previous occupations or activities of daily living.

Results:

The patients reported 90% improvement of physical symptoms suffered prior to surgical intervention. 15% had complete relief of symptoms and had returned to activities and work level they were at before their symptoms began. 80% have returned to light or full duty within six months of the surgical date.

Discussion:

Several factors affect outcome, some are under patient control and others are not. Patient compliance, tobacco abuse, and state of health are discussed as influencing factors that can affect the outcome.

Conclusion: The posterior lumbar spinal paramedian approach is comparable or better than the conventional approach eith results indications impressive relief of preoperative symptoms. Surgical advantages over the conventional approach range from easier exposure, less tissure damage, decreased morbidity to less blood loss.