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what is a 360??

rascal2717rrascal2717 Posts: 109
edited 06/11/2012 - 8:54 AM in Back Surgery and Neck Surgery
I am having an ALIF with cages (L-4 to S-1) and then I get flipped over for screw fixation and rods. Is that a 360?? And is it more or less painful than an open posterior fusion with cages, rods and screws. Am having surgery in one week and am starting to get really uptight and scared of the whole deal. Anyone know approx how long until I can sit for a couple of hours and approx how long until I feel like going out on a Sat night socially? Thanks for all your help. This site has kept me reading for hours and love the info!!


  • It sounds like your having a 360. Did the surgeon say what system or how they would do the rods and screws? My surgeon used the sextant system which greatly minimizes the amount of musclue that is interrupted during surgery.

    Recovery time depends on the individual. My surgeon didn't want me sitting in a chair for any longer than 15 minutes for the first few weeks.

    Much depends on what you consider "Socially". I wasn't in the mood to be around a lot of people for the first few weeks. As I got my stregth back and was able to walk further then I didn't mind so much.
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Sitting for a couple of hours will most likely be a way off. You will need to ask your Dr. what his feeling is. Its not good for people without back problems to sit for that long either. Puts lots of strain on your lower back. After having said that I went to a concert at week 5 and boy did I pay for it. Took me almost a week to get back to where I had been. Wasn't walking well at that point so that played into it also. I was determined that I was going and it was the one thing or a goal of mine to be able to go. Your having a big operation and it will take a good while before you really feel like going out on Saturday night. Not to mention the meds your likely to be on for a while. Some of it will depend on your age also. Good luck with your operation.
  • is one of the biggest of spinal surgeries .i will tell you what my consultant told me {UK} i will be in theater for between 5/9hours i will be in hospital for between 9 /14 days and recovery can take up to three years .the first years will be the worst .when it gets to ALIF/PLIF surgery your spine is in a bad way so make sure that your consultant is up to the job ..as that make all the difference .its very complex and needs someone with loads of experience .good luck
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • Thanks for all your comments. I believe I have a top-notch doctor performing the surgery. I had a laminectomy and fusion on the same levels 25 years ago and in the past year started having severe problems again. My prior surgery was was unbelievably awful and bone was grafted from my hip, which hurt more than the other back incision. Recovery took months and sitting was a long time coming. I thought that with all the medical breakthroughs and advances that the recovery might be easier this time. But, from what I am hearing it doesn't sound much better. The doctor is not going through my original scar on my back but rather is doing "percutaneous screw and rod fixation". Hopefully not cutting muscle if I understand correctly. I am scheduled to attend a wedding which will require 2 planes rides and 1 hour of travel by car 3 months post-op. I am wondering if this is something I will be able to attend or will it just be too difficult and painful to make the trip. I am told I will be in the hospital from 2-4 nights based upon what my insurance company will allow. Do you suggest that I get round-the-clock care in my home once I get home from the hospital? I am the type of person that likes to take care of herself and do not want to depend upon my husband and friends for help. My feeling is that if I can walk unattended, then I can walk myself to the bathroom and get a drink in the kitchen when needed. I have no problem hiring someone to be around during the day to bring me lunch and help showering etc, but, don't necessarily want to pay to have someone at night to watch me sleep. Does this make sense?? I appreciate any and all input. Thanks so much.
  • By 3 months, you should be able to travel. Notify the airline that you recently had back surgery and they should help accomodate you.

    You shouldn't need 24 hour care, but for the first couple weeks, having someone there during the day is nice. Remember, no BLT so get a picker up thing and a raised toilet seat with handles is most excellent. You will be constipated afterwards so the additional height and handles are nice all things considered.
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • First let me welcome you to Spine Health. This is a great place to find information about various spine conditions and to meet people who also have spinal problems and therefore can understand and sympathise what you are going through. We understand the nervousness before surgery as most of us if not all of us have been through it.

    Your surgery (from the front and then the back) is what is commonly called a 360 fusion.

    I had a circumferential fusion which set me into a panic when I heard what type of surgery lay ahead for me, as research showed that needed a front and back incision. However, my surgeon only did a posterior incision and was able to take out the disc and put in cages using special tools to work around the cord. Perhaps as he needed to remove the laminar and lots of bone of the facet joints, that made access easier. I was very glad to only need one incision!

    It may be that after the ALIF part, there will only be a need for one or more small incisions to place the screws and rods in.

    A full open incision from the back is supposed to be more painful because the muscles of the back have to be cut and stipped off the spine. Some surgeons tell their patients that they do surgery from the front because it is easier to recover from. I have only had a PLIF so I can't compare, but my recovery wasn't as bad as I had feared.

    I would imagine that having incisions in the front as well as the back will be no picnic!

    What are you having for bone graft? If you are having it taken from your hip/iliac crest, then you will probably have pain from there too. I was lucky in that my surgeon was doing a decompression which required bone removal from my spine so he used that as graft.

    I think you will find that 2 hours will be a long time to sit. If you can get up and walk frequently, between bouts of sitting, it will be easier. I had hoped to go to the theatre a few weeks after my fusion. No way could I do that!

    It depends what you want to do on a Saturday night. You will probably be able to meet up with friends for a short while, but you may be on medication that will disallow drinking and may need to be in a place where you can move around quite a bit. I found the best place to relax, for quite a few weeks, was to lie down on a bed so I could stretch out and be flat. We had a bed moved to the lounge which was great. My friends used to come round and I was able to lie down if I needed to, while we chatted.

    Only a week to go? Have you taken a look at the list of useful items for after surgery in the FAQs section at the top of this page? Also think about where things are located in your house. Anything you need to use regularly will need to be at about waist level because you won't be able to bend or stretch up to reach things. We also put the tv up high so I could watch it comfortably while lying down.

    I hope that your surgery will go to plan and that your recovery will be uncomplicated. Do let us know how you get on. You will find others here that will have surgery around the same time as you and it is great to have a surgery buddy to compare notes with.

    :H :H :H

  • Hi and Welcome.

    I had a 360 fusion with instrumentation on L4/L5 4 years ago. I was in the hospital a week and allowed to return to work after 3 weeks. I am very active so I think that helped. Full recovery takes a long time, it was a couple of years before I was able to do some of the things I had done before surgery (like ride my time trial bike!!). Be sure to listen to what the doc tells you about lifting, housework, driving, etc. I bought a pedometer so I could keep track of my walking. I have never liked walking much but when its all you can do it isn't so bad!!

    I organized my house so things I needed regularly that were in low cupboards were on the counter or stove. I got a long handled shoe horn which helped a lot. Socks are over rated and I wore clogs most of the time except for my walks. A grabber is a good thing to have too. Elasticized waist band pants that don't fit snugly. I was quite surprised that I could lie on my back without much discomfort with incisions front and back.

    PT is important, especially if you did not have a strenghtening routine before surgery and to work on scar tissue.

    Good luck and let us know how it goes.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
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