360 degree lumbar fusion is also known as an Anterior/Posterior Lumbar fusion. The procedure is an extremely common method for fusing the lumbar spine in which there is an incision anterior in the abdominal area and incisions posterior in the lumbar or low back region. The goal of the procedure is to stop abnormal motion at the involved level of the spine which is producing the pain symptoms. There are a wide variety of methods to fuse the lumbar spine. 360 fusion is considered one of the more successful methods however. The procedure is safe and is minimally invasive, especially in the skinny patient population. Typically the procedure requires two surgeons to perform – one who is an “anterior access” surgeon and the other is the spinal surgeon. The access surgeon is responsible for safely maneuvering into the abdomen and exposing the spine. Many times the spine is actually closer to the abdomen than it is to the back due to the thickness of the muscle.
Using the 360 technique for fusions limits the muscle dissection in the low back compared to other procedures such as the trans-lumbar interbody fusion procedure and thereby is less invasive.
The risks of the procedure are minimal when using an experienced access surgeon and spine surgeon. The procedure itself inserts an interbody cage between the vertebra that is filled with synthetic bone graft (the Anterior Lumbar Interbody Fusion procedure). This is combined with minimally invasive posterior incisions (usually less than an inch or two in length) to perform a posterior fusion with screws to hold the spine in place. The fusion rates of 360 fusion are the highest of any method to fuse the spine.
Patients usually stay overnight in the hospital 1-2 nights after this procedure. Pain is typically treated with IV patient controlled morphine for the first night and oral pain pills thereafter.
Once you have decided to have surgery, the following events take place:
Most patients can return to a light duty job within the first 3-4 weeks. No significant lifting for first 2 months.
Depending on the diagnosis, patients experience between 60-80% relief of their pain symptoms, sometimes even more.
As with any surgery there are risks. Stroke/heart attack/blood clot to the lung are the most serious risks, however these are EXTREMELY LOW risks. Bleeding and infection are the most common less serious risks and these too are VERY LOW risks. Less than 1/1000 patients could have a minor complication.
After the first 2-3 weeks your doctor will release you for sexual activity. Men have a 1% chance of having sexual issues after this procedure.
With modern bone graft substitutes, fusion rates are greater than 95%.
The hardware is mostly titanium, therefore it will not set off metal detectors