Anterior Versus Posterior Approach for Thoracic Corpectomy: An Analysis of Risk Factors, Outcomes, and Complications

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Thoracic corpectomies address spinal deformity, trauma, neoplasms, and infection.
• Both anterior and posterior surgical approaches are viable options.
• Comparative risk and outcomes data for these approaches are limited.

Purpose of the Study:

• To compare risk factors and complications in adult patients undergoing anterior versus posterior thoracic corpectomies.

Main Methods:

• A retrospective review of the American College of Surgeons National Quality Improvement Program database (2005-2016).
• Analysis of 1327 thoracic corpectomies (64.9% anterior, 35.1% posterior).
• Comparison of preoperative risk factors and 30-day postoperative outcomes.

Main Results:

• Posterior approach patients were generally older, male, with higher ASA class; anterior approach patients had higher BMI.
• No significant differences in 30-day reoperation rates (9.3% anterior vs. 7.1% posterior) were observed after controlling for baseline characteristics.
• Comparable rates of death, reoperation, readmission, length of stay, and medical complications were found.

Conclusions:

• Anterior and posterior thoracic corpectomy approaches demonstrate comparable safety and efficacy.
• Both surgical strategies present low-risk profiles.
• The choice between anterior and posterior approaches can be based on surgeon preference when either is indicated.