Spinal fusion surgery permanently connects two or more vertebrae to eliminate motion and stabilize the spine. A 360 spinal fusion is a comprehensive surgical approach, addressing the spine from both the front and back to achieve robust stabilization and pain relief.
Understanding 360 Spinal Fusion
Spinal fusion joins two or more vertebrae into a single bone. The “360” aspect signifies a combined anterior (front) and posterior (back) surgical approach. This can occur during the same operation or in staged procedures, where the anterior approach is typically performed first. This dual approach maximizes stability and enhances fusion success.
Fusing the spine from both the front and back provides greater stability than single-approach fusions. This comprehensive method offers a larger surface area for bone fusion to occur, which can lead to very high fusion rates, potentially over 95% in some cases. Surgeons may choose this technique when a patient requires significant spinal stabilization.
Conditions Requiring Spinal Fusion
A 360 spinal fusion is typically considered for individuals experiencing significant spinal instability, severe pain, or deformity that has not responded to other treatments. Degenerative disc disease, where the cushioning discs between vertebrae break down, and spondylolisthesis, which involves one vertebra slipping forward over another, are common conditions. Spinal deformities like scoliosis or kyphosis, spinal stenosis (a narrowing of the spinal canal), or stabilization after certain fractures or tumors may also necessitate this procedure.
The Surgical Process
The 360 spinal fusion involves distinct stages, often requiring two surgical approaches. The anterior approach, often through the abdomen or side, is usually performed first. During this stage, the damaged disc material is removed from between the vertebrae.
An interbody cage, a hollow, porous device made from materials like titanium or carbon fiber, is inserted into the disc space. These cages are often filled with bone graft material to promote new bone growth, ultimately joining the vertebrae. Following the anterior work, the patient is repositioned for the posterior approach, which involves an incision in the back.
In the posterior phase, pedicle screws are inserted into the vertebral bones, acting as anchor points. These screws are then connected by rods, which provide immediate stability and hold the vertebrae in proper alignment while the fusion process occurs. Additional bone graft material is placed along the back of the spine to further encourage bone growth and complete the fusion. Bone grafts can be autografts (patient’s own bone), allografts (donor bone), or synthetic materials, each contributing to the bone healing process.
Recovery and Rehabilitation
Recovery from a 360 spinal fusion is a gradual process, with initial healing occurring over several weeks to months. Patients typically remain in the hospital for a few days following surgery for pain management and early mobilization. During this immediate post-operative period, patients learn safe techniques for movement, such as getting in and out of bed without twisting or bending the spine.
Restrictions on activity are important to protect the healing spine. Patients are generally advised to avoid bending, twisting, and lifting objects heavier than a few pounds for an extended period, often several weeks to months. Physical therapy usually begins a few weeks after surgery, focusing on gentle exercises to regain strength, improve posture, and restore mobility. While full bone fusion can take six months to over a year, many patients experience significant improvements in pain and function within the first few months. Long-term recovery involves gradually increasing activity levels, with a full return to strenuous activities potentially taking up to a year.