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The vast majority (99%) had treatment including a posterior procedure, 25% had an anterior procedure, and 19% had a 3-column osteotomy.
The patient position remains unchanged for the second-stage posterior procedure.
Success rates of only 75 to 80% for the classic posterior procedure (lumbar discectomy) might still be challenged [ 7].
Patients could ambulate as soon as wound pain became tolerable after undergoing the posterior procedure for spinal stability.
For the posterior procedure, the average operative time was 102.5 minutes (range, 60 160 min) in the percutaneous group and 129 minutes (range, 100 165 min) in the open group (P = 0.001).
All enrolled patients were diagnosed with pyogenic spondylodiscitis and received anterior interbody fusion followed by a second-stage posterior procedure involving either open or percutaneous pedicle screw fixation, according to their own decision after receiving sufficient information regarding both approaches.
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RESULTS: The pseudoarthrosis rate was 17.5%, all occurring in patients fused to the sacrum in single posterior procedures.
A prospective randomized trial comparing the two-incision and mini-incision posterior procedures did not reveal differences in perioperative outcomes between these two approaches [6].
Looking at the published results for the classic posterior procedures such as conventional discectomy, microdiscectomy and percutaneous measures for treating HNP we observe heterogeneous results.
However, when considering the invasive nature and increased incidence of complications, we believe that the strategy of dividing the surgery into two smaller, staged posterior procedures is a safer option and reduces the need for additional corrective surgery should complications occur.
Tsirikos et al. carried out a retrospective review of 287 patients treated with the unit rod instrumentation with 242 posterior-only and 45 anterior-posterior procedures.
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