Anterior vs. posterior cervical fusion: Which is better? 6 key notes


A new study published in Spine examined anterior cervical fusion surgery compared with posterior laminectomy and fusion procedures with at least three levels instrumented. There were 13,662 patients involved in the study.

The researchers found:


1. The overall 30-day complication rate was lower in the anterior approach group. However, dysphasia was more common in the anterior group, with 6.4 percent of patients reporting dysphasia as opposed to 1.4 percent in the posterior group.


2. The complication rate excluding dysphasia with the anterior approach was 12.3 percent, significantly lower than posterior approaches, which was 17.8 percent.


3. There was lower hospital and total overall payments for the anterior group:


• Anterior hospital payments: $18,346
• Anterior total payments: $28,963
• Posterior hospital payments: $23,638
• Posterior total payments: $33,526


4. The patients recovering from the anterior approach had significantly lower 30-day readmission rates at 5.1 percent, compared with the posterior approach where there was a 9.9 percent readmission rate.


5. There were fewer revision surgeries for patients with anterior surgery — 12.8 percent compared with 18.1 percent for posterior surgery.


6. There was a shorter length of stay for the anterior patients by 1.5 nights.


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