Results of surgical treatment of low back pain: a comparative study of the anterior and posterior approach.

Comparative studies were made of 347 patients reviewed more than one year after the operation of disc excision for low back pain by either the anterior or posterior approach, many of whom also underwent inter-body vertebral fusion. In general the anterior approach proved superior to the posterior approach especially in cases of reoperation, largely because it avoided exposure of the spinal canal with the possible complication of bleeding or irritation of the nerve roots. There appeared to be no significant difference when fusion or no fusion was performed with an anterior approach, but with a posterior approach the results following fusion were superior to the nonfusion group. Consistently good results were attributed to correct patient selection rather than the choice of surgical technique.