The spinal column can be approached from the front of the body. Although this involves working around important structures, the reconstructive options are greater. The posterior approach involves stripping muscles off their bony attachments. This allows access to the spine, is safe and is commonly in use. However, it can cause postoperative pain, muscle spasm and recovery time is linked closely to the healing of muscles.
Anterior approaches heal quicker in comparison. Surgical experience and training in this type of approach makes it safe, and effective. Often, it is the primary approach for removing diseased bone when infected, replaced with a tumour or damaged by a fracture. The gap created can be replaced by bone or an inter-body cage. Based on the gap this frequently requires additional stabilization with implants to create an increased stability to be able to bear the loads and not need any external support.
In some more complex cases anterior approach is an adjunct to posterior fixation and the combined approaches allow for more robust spinal reconstructions for tumour, fractures, infection or spinal deformities.
There is an inherent risk of collateral damage to the visceral organs when accessing the spine. This requires a detailed discussion with the surgeon prior to the operation.