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Global or 360 Fusion?

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:21 AM in Back Surgery and Neck Surgery
Hello all,

I am 10+ months post op and my fusion is not happening. I had a TLIF @ L4/L5 w/instrumentation on Sept. 25, 2007. My doctor cannot explain why the fusion failed but had a fancy (to me) name for it, "Pseudarthrosis". Let me say here that immediately after the surgery the initial back pain I was having was 100% gone. There is significant sharp pain when I do any type of bending, extended walking, extended sitting, getting up from a chair or the couch etc. If I mow our 3/4 acre on the riding mower I can barely walk the next day. I have lost my balance and fallen twice. 2 weeks ago, 10 months out, I went for a follow-up, doc took x-rays and declared that the fusion was finally starting. At 10 months according to him, the fusion is supposed to be well under way and no further follow up appointments should be required. Not to get too excited about his observations, the following week he sent me for an MRI and CT Scan to verify his suspecions. I went in Monday of this week (8/04/2008) for a follow up and to learn his opinion of the scans. When he came in to see me, he seemed a little disappointed. He told me that while it looked on the x-rays that something was finally happening, the MRI and CT clearely showed very little if any progress which he said explained the sharp pain I am having when I do certain things.

He then said I had a couple of choices from here: Wait and see what happens. Could possibly take years to see any "real progress" or to seriously consider a "Global" or "360 degree Fusion". He told me that he thought the Global/360 Fusion was the better choice and had a better success rate (90%+) than the TLIF alone (70-80%) and his observations in his practice while the Global/360 Fusion basically consisted of 2 procedures done at the same time, recovery (healing) time was the same or less than the TLIF by itself. He explained that the 360 has a better success rate because the problem is approached both anterior and posterior.

I guess my question is, has anyone here had the Global / 360 Fusion? and/or has anyone had a failed TLIF or other fustion procedure and then a successful 360?

I think one of my conserns is my doctor told me that the hardware (screws/rods/plates and graph material) from the TLIF had to be removed and new hardware / graph material would be used. Why wouldn't a surgeon perform the 360 Fusion in the first place instead of a TLIF? :?


  • But maybe as they only go in from the back when doing a TLIF it is seemed as less invasive than a 360 therefore they may have thought that was the better option for you at that time. It's always easy to look back and wish they had done something different though! How bad is your pain? Is it manageable? If you are finding it is hindering your life then you may feel it's worth giving the 360 a go - I think I would. But one question I would want answering first, is if your body has failed to fuse with a TLIF, is it more likely that it will fail whatever fusion they use? I'm sure if surgeons even know themselves what makes some people fail to fuse and others not, but that's certainly something I'd want to know before I go any further. Might also be worth looking at getting at least one other opinion too, just to see what other surgeons think about your case.

    Good luck with whatever you decide. I am currently waiting for my 2nd opinion about what surgical option, if any, I have due to my own surgery failing so I do empathise with how hard this is. Let us know what you decide to do. Take care, Spicey
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