Lumbar fusions are operations that correct spinal instability or
replace a painful disc. Fusions are major surgeries. Every attempt must be
made to improve the chance of success while simultaneously reducing the
A lumbar fusion can be done using a posterior approach (from the back)
or an anterior approach (from the front). The best chance of success, and
the least invasive option, often includes both an anterior procedure and a
posterior operation. This type of fusion, called a “front and back” or a
“360 degree” procedure (like a circle), combines two smaller surgeries.
The posterior part of the operation is used to decompress the nerve
roots and place stabilizing hardware. It can be done with
invasive techniques and takes only an hour to 90 minutes. The anterior
portion of the surgery is used to replace the disc with a piece of bone.
It is also minimally invasive and usually takes about 45 minutes. This
type of fusion is safer than the still experimental total disc
The two procedures can be done on the same day or on different days. By
allowing the patient to recover for a few days between surgeries, the risk
of complications is lower, there is less pain, and the recovery is easier.
Even though a lumbar fusion can now be done using minimally invasive
techniques, it is still a major operation. Common sense dictates that it
should only be considered after all non-surgical options have been