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2 level posterior lumbar fusion

tcr1130ttcr1130 Posts: 122
edited 06/11/2012 - 8:24 AM in Back Surgery and Neck Surgery
Hi

Was wondering if anyone could give me details of post op and recovery following a 2 level posterior lumbar fusion...; doctor told me yesterday i will need a 2 level done ..... other than the 3-4 days in hospital and back brace for 6 weeks... id like to know how bad it will really be and what are the realistic things that are going to happen or i will go thru..

anyone that has gone thru it i would love to hear back from you

thank you

tammy
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1

Comments

  • I had a three-level (L3-S1) fusion in May. Now everybody recovers at a different rate, but mine went exceptionally well. Even then, you can count of at least 6 months of recovery when you have to be careful. Many people also need pain medication, I was fortunate that I did not. But regardless how well and how fast you recover, a multi level fusion is a serious thing and you need to dedicate yourself to do your best to recover. There is lot of good info on this site that helps you to prepare for your surgery (look under the stickies) and afterward. Also, there are a lot of "experts: here who can share with you their experiences.

    As i discovered, the three most important things for successful recovery are:
    a capable and experienced surgeon, a positive attitude from your part, and dedication to do the right things (e.g., WALK, WALK, Walk!).

    Wishing you an easy and successful recovery,

    Kin
  • im just plain scared to death... is one surgeon better with a lumbar fusion than another ( neurosurgeon vs orthopedic surgeon)....i just dont feel like i know enough to make this decision.... i know that i dont have any other choices i have tried them all.... but a two level seems a big deal to me... i just want to know more before i have it done... i dont i will stop being scared to death.. but think the more i know from people that have gone thru it the more it would ease my mind sometimes better to know the worse, and find out it wasnt as bad as you thought!!!!
  • I'm scheduled for a three-level fusion on November 19th. I had a couple of surgeons refuse to do it, because three-levels are generally not recommended. Two is usually do-able. However, I have not responded to any of the other treatments, including extensive PT. I just keep getting worse. Turns out that in addition to the severly torn discs, I have substantial arthritis in my lumbar spine. Without the fusion, my back will not fuse well by itself. So, I'm going for the fusion. I just have to have faith that it will be the best thing for me. There are lots of folks here who have had similar experiences and they are surely helping me to ease my mind.

    Linda
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • i had a two level lumbar fusion (ant/post) on Oct. 6th of this year. i had struggled with back pain for several years and got to the point where injections and PT were no longer working even after a microdiscectomy in 06. the constant pain was controlling my life and i decided it was time to proceed with the fusion. the first two weeks after surgery were the toughest...all postop pain and soreness. i was in the hospital for five days. by the end of the second week i am walking one mile a day. currently i am still taking pain meds but only at night to help me relax and sleep. i was really afraid of having this surgery especially only being 38 yrs old but my back feels stronger than it has in a long time and i am very optimistic about the future. i used an ortho surgeon. let me know if you have any other questions...
  • "As i discovered, the three most important things for successful recovery are:
    a capable and experienced surgeon, a positive attitude from your part, and dedication to do the right things (e.g., WALK, WALK, Walk!)."

    This is absolutely right.

    I would suggest that you get another opinion before you make a decision as a different Dr may have an approach that is better for you or he may just tell you that the first one was right and you will feel better.

    You will read about the good, the bad and the Ugly here and that is because we all have different experiences.
    Neither surgeon is better, but you must make sure to have a spinal surgeon eityher O/S or N/S.
    Read as much as you can as a fusion is not a walk in the park (well it will be when you get out there LOL) and does require dedication to a strict lifestyle.
    I see you have had a cervical fusion so you have an idea but from what I have heard a lumbar takes more to recover from.

    I had a 3 level with correction to scoliosis so quite a bit different to what you may have. But you will need several months off work and to have your house prepared for not BLT bending lifting or twisting. You will need help areound the home for a while as it is too easy to think 'I will just do that". You may or may not have pain, I have noticed that often the pain kicks in when the brace is weaned off (I didn't have a brace) and PT is started.
    I dont think you can ever be fully prepared and I have seen some people here just sail through their surgeries and then off to the distance which is great, while other take a bit longer to get there.

    Keep going to aquatherapy and strengthening your core muscles as much as you can.

    Blessings Sara O:)

  • quote -

    [Kin said

    "As i discovered, the three most important things for successful recovery are:
    a capable and experienced surgeon, a positive attitude from your part, and dedication to do the right things (e.g., WALK, WALK, Walk!)."

    This is absolutely right.]

    Ditto angle back and Kin.

    also apply a little bit of your own commo sense here too. If your guts don't trust what your told, seek another opinion. That goes for PT, NS, OS anyone really!

    If you have a doubt - weed it out
  • I was very scared of the recovery process as well. I ended up needing help for 7 weeks because I got an infection. most people don't, so don't dwell on mine! before deciding on the surgery, I remember going outside at night when the kids were in bed and my husband wasn't home from work yet and just bawling. praying. seeking peace. I am 37 and had dealt with back pain issues for over a decade. Once my neurosurgeon convinced me this was the best option (3rd opinion, all said the same thing but this one clicked with me) then I read read and read. I decided if others could go through this and be success stories, I could, too. the recovery process was one day at a time. lots of pain for sure, but also lots of meds and lots of rest which most always helped. Now, I still have pain, still take meds, but it's different pain and I know I'm getting better and better. no regrets. oh, I had a two level fusion like I think you're having- L3-L4 & L4-L5. if this is what you need, you can do this. hundreds of people do it every single day. you're strong, I am guessing, after having dealt with so much pain & all the procedures many of us have been through. I had two neurosurgeons tag-team for my surgery. my humble opinion, I prefer a neuro over an ortho for a fusion. I had an an ortho do my laminectomy. that didn't go so well, but not entirely blaming him. he just took too much bone out which added to my instability problems down the road. anyway! ask questions, vent, being scared is very normal. for me the fear was like for two weeks. I could barely breathe sometimes from the anxiety. I didn't talk to my kids til I felt positive about it. I did cry with my husband several times. he would listen and then tell me everything my neurosurgeon had said to me, why it made sense, why I needed it. it felt good to be reassured by my husband. :)
    best wishes to you.
  • you will know when it is time....you won't want to deal with all the restrictions your life contains due to your back and the pain will not be something you can function over the top of very well. Talk to lots of ppl and find out who has done well with fusions in your area. You could post your general area and ask ppl here to pm you if their surgeon is nearby. You at least want two opinions, if not more and make sure you have tried extensive PT, injections, massage etc. to the point where you feel you have exhausted your options. If that's where you are at you will be very nervous but you know you need to get your life back. I had the same two levels, but a year apart. (we knew that would probably be the case, but were hoping to just get by with one) I am 5 mths. out now, almost done weaning the brace, am walking 3 miles, back to making dinner and carpooling but I'm still healing and my life is dedicated to the 1-2 yrs. it takes to totally heal. You will find many stories and advice here that are amazingly helpful, especially the threads on successful surgeries~check it out.
  • It is very wise of you to learn as much as you can prior to surgery. I did not - I think because I did not want to hear any possible "scary" things - but then had to learn quickly after surgery to try to figure out if what I was experiencing was normal. Fortunately, I had 2 friends who had recent lumbar fusions and I found this site which is truly filled with great info. I did access one of the lists on this site "Post-Op Must Haves" prior to surgery and am so glad I did - the list is very "on target".

    I agree that whether neuro or ortho you will want a spine specialist. Again, on this site there is a list of questions to ask your surgeon before making a decision.

    The first 2 weeks home from the hospital were the most difficult for me - after that, recovery has seemed not so much painful as long, slow and boring. But now at almost 3 months post-surgery I am finally getting back to a more normal life - I just have to keep reminding myself that if I over-do I will be tired and achy later!

    Wishing you a successful surgery and pain-free recovery!
  • thank you for all your comments.... i have exhausted all my options..... over the last year i have had over 20 steroid shots... rhizotomy.... land based therapy and the aquatherapy..... the spect scan and discogram confirmed everything......

    peoples personal experiences mean a lot to me right now... not medical advice per say... more what you went thru... leading to a surgery, after you came out of surgery.. your recovery at home... i think it would scare me less to know some things up front... because i am pretty much thinking the worst right now....

    I meet with the doctor nov 12th.. i have till then to think not of whether i am having it done.. its when.. and how bad with it be..... he tells me then if i am a candidate for a two level xlif - otherwise it will be a two level plif

    thank you for all your comments!!!!! it is so appreciated it
  • I can understand your need to know what to expect - sometimes it is the unknown that is most frightening!

    What kind of help will you have at home after surgery? I found that for the first couple of weeks I needed help for almost everything. My husband and a friend who had had this surgery herself waited on me hand and foot. And while I likely could have done more for myself it was very very not to have to. For example, during the first few days at home when I was taking pain meds every three or four hours they even got up in the night to make sure I had the meds on schedule.
    After the first two weeks I could do more for myself - as long as what I needed was at about waist to shoulder level so I could reach it. I used a walker for about 2 to 3 weeks for stability. Although I was able to go up and down stairs, it was exhausting - but just about everything was exhausting at that point. I stopped pain meds after about 2 & 1/2 weeks because they made me feel so bad - and the pain was OK. Ice and heat helped a great deal. I found it difficult, however, to find comfortable positions for sleeping - it was not painful, just not comfortable; even harder was finding any place comfortable to sit for even a few minutes. There is quite a bit on this site about both of those issues.

    As I said before, I found recovery to be long and slow. You will want lots of simple diversions - DVDs, audio books, music, - things that you do not have to sit up to do.
    Most of the time for at least 2 months I was either walking or lying down.

    Terri, Lakeside and others have posted some other great post-surgery info under the topic "Please post surgery patients be very careful ;) UPDATE" (sorry I don't know who to put the link in). Take a look - there are good descriptions of th recovery period.

    Again, best of luck with your surgery and recovery!
  • The thing you really need to understand, that we probably can't fully understand until after surgery, is that it is a very slow and long road. You will need to pace yourself, not will yourself, into doing things. I am very headstrong and impatient but listened to everyone here that told me not to expect anything all at once but in baby steps. Also, I was told a full year to 2 years for complete recovery, though after 6 months you will notice a difference. I'm almost to 6 months and that advice has been right on. Measure your progress afterward from doc appt. to doc appt. not day by day or you'll be banging your head on the wall. Get lots of projects ready to complets...make a long list.....cleaning out the junk drawer, organize sock drawers (have someone put them on the table for you and work little by little all day on one drawer), scrapbooking, putting pics. in albums etc. Then after surgery, when you begin to get stir crazy, leave that list out and focus on those things not your healing. Time will go quicker. And above all, say your prayers and keep a positive attitude. Do not let yourself sulk; keep that chin up. Soon you will have a new life and new beginning.
  • Well have avoided it as long as i can... have to meet with the neurosurgeon to set up the surgery .... just hard to wrap my mind around this - scared i guess!
  • they will be deciding amongst the neurosurgeon world whether i will be a 2-level xlif, or a 2 - level plif .
    He said my recovery experience about the same for either..... stitching will be different... only thing is no one the area i live has ever had a xlif done - they've only done onle level lifts........

    i have dentatively set up the surgery for the 29th of december....... they can do the tlif then - if its the xlif dont know when they do that..... need three different surgeons for that and one is gone xmas to new years...

    doctor warned me today they dont have much long term information on this xlif - thats why he is having a hard time giving it as on option to my surgery.... so for next couple dates i get information, read up.. and be ready for the phone call.........

    thanks

    tammy
  • I had a 2 level fusion done Jaunary 28th this year i was in the hospital until the 30th and due to wear the brace for 6 weeks I think my recovery went pretty well considering the surgery wasnt really the problem my pain was well managed ( other then i hate the drugged feeling) I needed help quite a bit the first week to ten days just getting in and out of bed and too the bathroom my recovery was hindered for personal reasons i lost my father the day i was released from the hospital and then lost my mother 49 days later so recovery for myself was harder but i honestly think my physical recovery went alot better then i expected at least for the 2 level lumbar fusion good luck
  • thank you for your post - i am so sorry for your losses.. i cant imagine how hard that must of been for you!! its been almost a year since your surgery .. are you glad you had it done.... they say a year for a full recovery .. do you feel you are there!?????
  • Yes i am very glad i had the lumbar fusions i have almost 75% of the feeling back in my legs and feet now its the muscal pain fron healing which after the pain from before is a hoilday however now they have found DDD in the thorascic in several spots so i am having pain there but the lumbar surgery was the right option for me and also i wanted to note i had a neurosurgeon as opposed to an ortho i saw both but the neuro made me feel safer and bluntly his bed side manner was MUCH better take care and i hope you have great results!!
  • Well they have decided the "tlif" is the way to go - so i will have a two level tlif l3-4, l4-5 right after christmas..... i am a little uncomfortable right now with things going on.... the office has been 3 weeks callin to schedule stuff - the doctor says he will call and doesnt.... just a tiny uncomfortable with stuff... im sure for them this is not a big deal surgery - but for me it is... and i wish they would treat it like it is!!!!

    little upset with todays visit.. had to actually get my pain management doc to call the surgery scheduler at home - to reanswer all the same questions i had told her two weeks ago..... i have had this office since they did my neck surgery back in 06 - i had the best surgeon in this area do my neck one level fusion - now i am getting his associate to do my two level lumbar.. and im still waiting for him to call from nov. 12th - shouldnt it be easier than this!??? should i be the one to be made to feel like the nag for having to recall the office because no one calls me..... i wish i felt more comfortable with this... but right now i dont! and i am at the point i cant wait any longer to bring a brand new office/surgeon on board..... i hope things change next week!!!!
  • Surgically, I think you will do fine. I was having horrible pain in my legs when I got home and they have prescribed Lyrica, which is really helping. Just make sure you have someone at the hospital with you who will look out for your needs. There are great care givers in all hospitals and there are some really crappy ones. While my hospital experience was horrible, I'm now almost two weeks post-op (for the second surgery I had in 5 days) and I walked over a mile today. I'm tired, but I feel well. I think the healing is going great.

    Linda

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • i.m 10 days post-op L4 & L5 Fusion. i understand what you are wanting but i think you need to understand the procedure and let it happen. like most here have said its different for everyone and having folks tell you what you may or may not go through is not a good thing. i will say you can get through it so far i have. i have someone i met here (name is Chuck) who is three weeks ahead of me with the same procedure and hes been alot of help. if you need keep in touch as i will be "in front of you" were all in this together and if you havnt went through this before its hard for them to understand. e-mail is terry_greer23@hotmail.com

    sorry for the typos and spelling im doing this from my back in bed.

    Terry
  • I had the opposite experience from Isteller. The hospital I had my TLIF done in was wonderful to me. The nurses were great, too. My meds were given to me on time and I really had no problems with hospital/staff at all. I was alone at night since daughters and son have full-time jobs and couldn't be there. They kept me pretty sedated so I don't remember being in horrible pain.

    Prior to surgery, I was given a date but no specific time until like the Monday before the Tuesday surgery. They waited to give me a specific time in case someone came in with a greater need than mine. My doctor was absolutely wonderful--top notch all the way and a great bedside manner. Relax, you will do just fine!
  • Wow. That sucks that they don't seem to be on the ball. When I call my Neurosurgeon's office, I get a call back that same day. They are very attentive, very thorough, very efficient and timely.

    I'm really sorry to hear about your losses. That is a lot to handle at one time. What doesn't kill you makes you stronger, but those down times can be brutal emotionally.

    I wish you the best of luck with your surgery!
  • Gosh, I do understand what you mean, this is such a big deal for you but for them it is just one in dozens they do every month.
    I think you need to say that to the PA at the surgery and just let her/him understand that you are scared and need a bit of TLC and understanding.
    The main thing though is that your surgeon knows what he is doing :))( and I am sure he does.
    Blesisng Sara O:)
  • Hi Tammy,

    I just had the 2 level TLIF 4 weeks ago, with hw at S1/L5/L4


    Take a look at my thread, it may provide some insight.

    http://www.spine-health.com/forum/back-surgery-and-neck-surgery/lumbar-tlif-fusion-post-13-days-feeling-great

    Be strong and get well soon.
    Tom
  • Well i cant believe it they finally called today - surgery is dec. 30th - pending any change from this colorectal surgeon i have to see on the 17th - i guess we will go forward this after christmas

    if there was a little smiley up above that was shaking profusely i would add it to my letter but i dont see one....

    i have been reading thru all the info and all the threads you have sent - thank you

    found a pre/post surgery list someone had put on this site - so will go thru all that and see what is needed.....

    right now i just have my cane and grabber tool :''(
  • info

    what is a bone fusion stimulator - i havent heard my neurosurgeon speak of it... i meet with him on monday to have my last chat before my two level fusion on the 30th - should i bring this up - or do they just do it in the hospital???

  • Hi TCR, a bone fusion stimulator is a device that emits an electromagnetic field over the fusion site. It is suppose to help facilitate fusion. My surgeon gives them to all his fusion patients regardless, but many surgeons only give them to people at risk for failed fusion, such as smokers or redo fusions. Mine is only worn for 30 minutes a day, but for 9 months. Others are worn for 4 hours a day, 24 hours a day. Some are even implanted internally during the surgery. I will post a link to mine. Good luck with your upcoming surgery. Cali-Sue

    http://www.djoglobal.com/bonestim/medpro/spine.asp

  • You may want to also look at my postings about my experiences. I am now 9 days out. My PM in the hospital was really bad. I don't know if part of it was because I had been on pain meds for over 5 years. But I also one really bad nurse and we ended up contacting the senior nursing staff about her. The best thing I would say is make sure you have someone there to advocate for you. My family didn't stay overnight, but the daytime was enough. Also make sure to take advantage of the PT staff in the hospital and get up and walking as much as you can. I can tell you that it really helped me feel a lot better being up. Also, if things are bad don't be afraid to ask to stay longer. I stayed 3 nights instead of two.

    As far as the bone growth stimular, the rep brought mine to the hospital and showed me how to use it. I have to wear mine 4 hours a day, but I don't feel anything with it on, it is just bulkly and somewhat uncomfortable laying down with it. But it really isn't bad at all.

    But I don't want to scare you too bad, once I got home things have gotten a lot better every day! I would be glad to answer any questions that you have!

    Julie
  • Well i guess it all gets closer when you know the next time you see your neurosurgeon you will be naked in a paper towel robe.

    my doctor is assisting with an xlif in buffalo today - he is presenting my case to him - so i suppossed there could still be the possiblity of a two level xlif - otherwise we proceed with tlif

    he has said i wont wake up in a brace - but anytime 45 degrees or further i have to have it on... they will get me up the second day - 4-5 day hospital stay and about a 5 hour surgery... said i will get the bone fusion stimulator at my two week post-op appt - and will do that 4 hours a day for 9 months....

    brace for 6-8 weeks - and pt decided as we continue as to when that starts..... two weeks from today - scares the piss out of me... i see myself getting short with people... i know my stress levels are rising as this gets closer.. and that sucks with christmas coming - i want to be able to turn that off not think about it - but its always there.......

    post op at hospital tomorrow.... it just comes so fast...........

    does my 2 level sound like what most of you have gone thru with a two level!??? similar time frames etc???

    they are going to have a hard time with me and pain pills.. as most of them give me horrible stomach pains.... so tomorrow i will try a fentanyl patch - i tried 25mcg and it made me so nauseous i ripped it off my arm in the middle of the night - took another 10 hours before it stopped.. so tomorrow i will try the 12.5 the also gave me phenegral for nauseau to take with em.... but thats for the pain now.... cant imagine how they will handle it after... i cant take vicodin .. have had problems with percocet,.. problems with higher levels of kadian..... stomach just cant take it...... but thats why im seeing my gastro this week... i need his help to get thru this... they are going to destroy my stomach with this stuff....

    thanks for posts and support
  • have you tried dilaudid? I do well with that post op since I am allergic to morphine and they can put it on the pain pump. As for what to use after that, they make an oral dilaudid as well....hope that helps.
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