surgeryposterior

Posterior surgery, or a posterior approach, is a term used in medical practice to describe procedures performed through the back or from the dorsal aspect of a region. The posterior route is chosen when the surgeon requires direct access to posterior elements, neural structures, or when anterior exposure is difficult or less safe.

Applications include several surgical specialties. In spine surgery, posterior approaches provide exposure to the vertebral canal and posterior elements and are commonly used for decompression (such as laminectomy), stabilization with pedicle screw constructs, and fusion. In orthopedic surgery, posterior approaches are used for certain hip procedures, including posterior total hip arthroplasty, and for some shoulder or pelvic procedures. In colorectal and gynecologic contexts, posterior incisions or access paths may be used for limited pelvic procedures or to access posterior vaginal or rectal structures, depending on pathology.

Considerations involve balancing exposure advantages with potential morbidity. The posterior route often offers direct access to posterior anatomy and can spare anterior viscera, but it may involve dissection of back muscles, higher risk to posterior nerves, and wound complications. Modern techniques emphasize muscle-sparing approaches, meticulous hemostasis, and neurovascular protection, often aided by imaging guidance. Postoperative rehabilitation depends on the specific procedure, approach, and underlying condition.

History and training notes: The posterior approach has become a standard component of many surgical subspecialties, particularly spine and orthopedic surgery, with specialized training in relevant fellowships. Surgeons weigh exposure benefits against potential complications when selecting a posterior route.

See also: anterior approach, lateral approach, minimally invasive surgery.