Anterior/posterior lumbar interbody fusion surgery, or 360 degree fusion, is a combination of anterior lumbar interbody fusion and posterior spinal fusion procedures. Fusing the front and back provides a high degree of stability for the spine and a large surface area for the bone fusion to occur.

During the procedure, the surgeon first approaches the spine through an incision in the abdomen. The affected disk space and any arthritic areas are removed from the spine and replaced with a bone graft. Titanium screws and plate are inserted into the front of the spine to add stability. Then the patient is turned on his or her stomach, and an incision is made in the back. The remaining disk space is removed from the spine and replaced with a bone graft. Titanium screws and rods are inserted into the side of the spine to add stability.

Anterior interbody cages are inserted into the lumbar disk space from the front. They can be made of allograft bone, titanium or carbon/PEEK. Posterior lumbar cages are inserted into the lumbar disk space, but are modified to be inserted from the back. They can be made out of the same materials as an anterior cage.