Chronic back pain caused by abnormal movement of the vertebrae raises questions about appropriate treatment. A 360 degree spine fusion, also known as an anterior and posterior lumbar fusion, may be recommended by some surgeons to patients dealing with major deterioration or damage of the lumbar vertebrae and other spine conditions.
If your doctor has recommended 360 lumbar fusion, and you have doubts or concerns, a second opinion on spine surgery with Dr. David Barnett can provide the answers and clarity you need. Many spinal conditions can be effectively treated without going under the knife. Whether you were diagnosed with spondylolisthesis or degenerative disc disease of the lower back, Dr. David Barnett prefers to exhaust all conservative modalities before turning to minimally-invasive spinal surgery.
Second Opinion on 360 Degree Spinal Fusion
You have been told you need a combination anterior and posterior spinal operation. Now what? Dr. David Barnett gives the following advice:
“While there are circumstances under which this type of lower back surgery might be beneficial, the vast majority of patients can be successfully treated without undergoing this extensive procedure. Having more than one incision or approach unnecessarily increases your risk of infection, pain during recovery, your hospital stay, your recovery time, and the likelihood you will need narcotic pain medications.
In over 26 years of a very busy and successful practice, I have found that the vast majority of patients do not require this anterior/posterior, front/back, or “360” procedure which I find to be a very aggressive way to treat most patients. The indications that might require this approach would include cancer, scoliosis, or severe trauma.”
Anterior and posterior lumbar fusion surgery is generally indicated in patients with a high level of spinal instability that puts pressure on spinal nerve roots. The purpose of the operation is to stop abnormal movement between the affected vertebrae. It can eliminate symptoms like low back pain that worsens during certain movements with radiating nerve pain that extends to the thigh and buttocks.
However, the procedure is lengthy and invasive. It involves the insertion of a device called an interbody cage made of carbon fiber, titanium, or medical-grade plastic. The operation typically requires two surgeons who can approach the affected spine from the front and the back. This interbody cage contains bone graft material that helps the vertebra fuse together over time. Screws and other hardware are placed to stabilize the area until fusion takes place–which can take 6-12 months.
While this combined approach has high rates of spinal fusion, the surgery carries the inherent risks of both an anterior and a posterior lumbar fusion.
Less Invasive Options Available
Minimally invasive techniques in spine surgery promise smaller incisions, less blood loss, and faster recovery times. While some patients may benefit from two-stage 360 fusion, surgery is usually the last resort after more conservative treatments have failed to achieve positive results.
Non-surgical alternatives may include physical therapy, steroid injections, muscle relaxers, and pain medication.
Consult with Dr. David Barnett
Before consenting to this procedure, seek a second opinion with Dr. David Barnett, an expert Dallas neurosurgeon and specialist in spinal care to see if you are a candidate for a more conservative approach.
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