Simultaneous combined anterior and posterior fusion. A review of its concept and 10 years of refinement of the technique: a solution for the patient with severe back and leg pain.

This paper reviews the principles, developments and concepts embodied in the experience gained over 10 years with simultaneous combined anterior and posterior fusion (SCAPF) of the spine in over 750 patients. The procedure was initially designed for the surgical treatment of failed post-discectomy syndromes. Indications have expanded due to increasing experience and the rapid, predictable fusion which accompanies this technique. The current technique allows for a solid anterior fusion combined with extensive posterior decompression and removal of the primary anatomical pain sources involved with low back pain and disability.