Anterior/Posterior Fusion

An anterior/posterior fusion is a spinal surgery involving the fusion of the front (anterior) and back (posterior) of two or more vertebrae in the spine. The purpose of the procedure, also known as a 360 degree fusion, is to stop the pain-inducing motion of zygapophysial joints (facet joints) of the spine caused by degenerative disc disease, osteoarthritis, fractures, or spinal deformity. This fusion is typically performed in the lumbar region, or lower back.

The procedure fuses together unstable vertebrae by securing bone grafts and other stabilizing hardware (such as a titanium cage) inserted into the intervertebral disc cavity and secured with plates, screws, and/or rods.

Steps of Surgery

Anterior/posterior fusion is actually a combination of two surgeries, often used on their own to treat different occurrences of back and neck pain. Performing both procedures in certain situations may provide a higher level of stability than one or the other separately.

The anterior/posterior fusion begins with an anterior lumbar interbody fusion (ALIF). With the patient on his or her back, a large incision is made in the lower abdominal region. The muscles and internal organs are moved aside. The surgeon then has access to the anterior (front) portion of the lumbar vertebrae. The intervertebral disc material is removed from the front half of the disc and a titanium cage may be inserted to support the vertebrae. Bone grafts are then attached to the cage. The patient is closed up, bandaged, and turned over to complete the final stage of the surgery, a procedure called posterior lumbar interbody fusion (PLIF). A large incision is made in the lower back. Access to the vertebrae is not as easy as the ALIF, as the back muscles and posterior vertebral segments block access to the disc and may be removed. The remaining disc material can be cleaned out, and another cage and bone graft can be inserted. It can take up to one year for the grafted bone to completely heal to the vertebrae.

Disadvantages

There is a long recovery time required after an anterior/posterior fusion. The bone grafts may not fuse to the vertebral bone and the surgery may have to be repeated. Stiffness and reduced mobility may also be possible, but the potential reduction of pain may outweigh the other symptoms.

An Alternative to Open Back Surgery

Open back surgeries such as an anterior/posterior fusion can be complex, risky, and require an extensive period of recovery. The minimally invasive procedures offered at Laser Spine Institute are a safe and effective alternative to open back surgery. Our orthopedic specialists use state-of-the-art endoscopic techniques to perform our procedures, which have helped tens of thousands of people find relief from back and neck pain. Contact us today to see if these procedures are right for you.