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TLIF surgery to fuse L5 to S1

shazzasshazza Posts: 66
edited 06/11/2012 - 8:26 AM in Back Surgery and Neck Surgery
Im on a waiting list for surgery and would like to hear others story and outcome who have had the same surgery.

I have severe degenerate disk and appears black on the mri scan, as if it has dissapeared. I have been advised to have TLIF surgery and didnt realise how many different forms of fusion surgery there were!

Im really interested in reading others story that are thesame as mine....symptoms, operation and how the healing process was afterwards


  • My pre-surgery pain is mostly gone. But I have new things going on, and I have old pain that was not associated with the discs that were operated on.

    I will tell you that my doctor told me (after surgery, in recovery) that TLIF is minimally invasive, and the recovery time is faster. But, that the immediate pain from it surpasses a PLIF exponentially. Yeah, I thought gee doc, thanks for telling me this NOW!!! :O

    Anyway good luck. Research research research!

    One Love,

  • I had on-and-off low back pain for 19 years. It started after moving greeting card racks at work. I would experience 3-4 major flare-ups per year, lasting 2-4 weeks each time.

    In August 2007, I was on the golf course and without any warning, experienced another flare-up. This time, the pain eventually eased off, but definitely not to the point it usually does.

    I tried PT, acupuncture, chiropractor and massage. Nothing worked so I finally went to my doctor who sent me to a physical medicine specialist. He ordered an MRI that showed a bulge at L5/S1 displacing the S1 nerve root.

    He sent me to a pain specialist who did a series of 3 ESIs and also had me on a TENS unit. This also did not work so he referred me to my surgeon.

    My surgeon noted that beyond what I knew, the disc was severely dehydrated and degenerated. He gave me the option of doing a fusion now, or a discectomy now and fusion later. The timing was right, and I wanted to limit how much doctors messed with my back, so I opted for surgery.

    My procedure was a single-level PLIF, partial laminectomy and decompression. The fusion was done with two facet bolts and a hard plastic cage with BMP. My surgeon invented the facet bolt system and I was willing to let him do it (it was approved by the FDA in 2006). By doing the facet bolts, my surgery was only 1.5 hours.

    I am now 4.5 months post-op and my recovery has gone well. Make no mistake that it is a long, sometimes painful process, but I have found it to be not nearly as bad as I thought it would be.

    My pain was mostly under control the first day with a morphine pump, though by the next morning, the morphine didn't work anymore. They switched me to Percocet and within an hour it was much better.

    In the hospital, on the day of surgery, in the evening I stood up, shuffled over to a chair and sat for roughly 1 hour. The next day involved sitting in the chair again and a short walk in the hallway. The following day, I walked around the entire floor, showered and went home in the afternoon.

    At home, all I did was sleep, lay on the couch in front of the TV, and walk outside once or twice a day. The first walk was 90 steps to our mailbox and back. Each day, I increased my distance, so by the end of week 1 at home, I was walking 1/4 mile at a time. By the time I got to 5 weeks, I was walking 4-6 miles per day, split in 2 outings - one in the morning and one in the afternoon.

    I had a slight "setback" when my swelling went down. Every little movement hurt, but this gradually decreased.

    At first, walking was at a snail's pace (actually, a snail probably could have beaten me in a race). However, speed will slowly increase. Your body will tell you if you're going too fast or trying to do to much. LISTEN TO WHAT YOUR BODY TELLS YOU.

    At 3 months, I no longer had to wear my brace, and was also allowed to start other exercises. My surgeon gave me a home program, though other doctors prescribe formal PT. My restrictions were removed, except for not bending or twisting repetitively and not lifting more than 25 pounds.

    I still have some pain and sitting is still occasionally an issue, but overall, everything is going well. The original pain is gone - noticeable since week 2.

    Recovery is a slow progression. The best advice I can give you is don't wake up everyday and try to determine if you are doing better. Improvement is so slow that you will not notice any change day-to-day. You will drive yourself nuts and get depressed if you do this. Instead, compare week-to-week. You should be able to notice some improvement each week over the past one.

    Also, when I increased the distance I walked everyday, part of the reason for doing that was to give myself something that was an improvement over the previous day.

    Sorry for the long post. I hope it helps give you an idea of what to expect, though everyone does heal differently.

    Good Luck! :)))
  • On Dec 22, I had TLIF surgery on L5/S1. The surgery went real well and I am now back at work. I have read many posts from others who have undergone the same procedure, and it appears that each person's pain and recovery time is unique.

    As far as my story, I suffered from spondylolisthesis, most likely as a result of some sports related activity in my youth. Spondy was causing the disk to compress and also pinching the nerves going down my legs. The first symptoms appeared approximately a year ago, and was not very bad. Left leg would get a tingling feeling after standing for 10 minutes. Progressively the tingling feeling got worse, by the time I had surgery, I was not capable of standing for more than 2 minutes.

    My doctor suggested many different types of treatment before surgery. He believed that surgery should be a last resort, and I concurred. I tried getting epidural type injections - they did not work. Than he prescribed physical therapy. PT worked to a certain degree, but did was not to my satisfaction. After exhausting all options, I had TLIF done on Dec 22 to fuse L5/S1.

    By all accounts the surgery went well. 5 hours after surgery, my doctor had me get out of bed and attempt to walk. It was painful, but I was able to walk from one side of my room to the other. The 2nd day post surgery I was able to walk around the entire hospital floor. Pain was still there, but very manageable. By the 3rd day I was walking around the hospital floor multiple times, and began going up and down stairs (7 step rehab stairs). The fourth day I was discharged and went home.

    The pain throughout my hospital stay was very manageable. I was hooked up to an IV, which contained a self-medicating pain reliever (possibly morphine). I used that a total of 8 times during my stay. Most of the use came between the 2nd and 3rd day, when the anaesthesia completely wore off and my body was reacting to the surgery.

    After being discharged, I was perscribed percocet and a muscle relaxer. I took a total of 6 percocet and 2 muscle relaxers, before I realized that the pain was manageable through otc tylenol. By Dec 30, I was completely off all medication. By the start of my 2nd week post surgery, I was moving around the house pain free. By the end of the 2nd week, I was able to drive my car and go places.

    In all honesty, I could have probably returned back to work after the 3rd week, but the doctor advised that I stay out a full 6 weeks. Weeks 4-6 post surgery have been like an extended vacation. I would get occasional muscle aches in my upper back, but that was caused by my improved posture.

    I had my first post surgery doctors visit 4 weeks after surgery. X-rays were taken and everything was as expected. Doctor advised that 3 months post surgery, i would have all physical restrictions lifted, but until than, i was limited to a 25lbs lifting weight restriction. I was not allowed to swim or run, but was allowed to use an elliptical.

    Feb 2, was my first day at work. I am completely pain free, and all previous symptoms I had prior to surgery have been gone since the surgery. I think my surgeon did a terrific job, but I also believes the success and post-op recovery is all dependent on the patient.
  • I am two months out from my two level TLIF. Five years ago I had a lamenectomy at L5-S1, which helped my nerve pain, but I had ongoing back pain. After trying about everything available and seeing 4 different surgeons I decided to have the minimally invasive TLIF on December 3.

    My recovery has not been as easy as Sak. During my hospital stay I had a lot of post-op pain. It didn't help that I had a bad nurse who didn't bring my meds on time. However, I was actually anxious to get up and walking and did walk around in the hospital a lot and was going up and down stairs. Originally I was supposed to be in the hospital for 2 days but ended up staying 3.

    Once I got home things were easier. I got my stiches out 9 days after surgery. Unfortunately the incision opened back up the next day and was bleeding so I had a trip to the ER to get stiches back in.

    About a week later I developed nerve pain in my right thigh, and now when it doesn't cause pain it is numb. For my left thigh I have been having nerve pain when I lay down at night.

    I have been doing PT since the beginning of January and I really feel like I have recovered from my surgery pain. My energy level has improved a lot. However, I believe that the nerve pain in my legs that I didn't have prior to surgery is really holding me back. I haven't been able to get off my pain meds. The nerve pain is also causing me to loose sleep some nights.

    Right now I am working from home still. If I didn't have over an hour commute to work I might be back, but I feel like that along with an 8 hour work day would be too much for me. On days I don't have PT I have been walking on my treadmill and doing my core strengthening exercises. I have also lost almost 10 pds since the surgery.

    I have a follow-up appointment and x-rays next week so I am anxious to get some feedback from my surgeon. I am frustrated with the nerve pain that I didn't have prior to the surgery. I have been told that this does happen sometimes. I am hoping that it will go away soon.
  • My surgery was 7 months ago and I still have not fully recovered. I also had the spondy thing going on, etc., etc. All of my pre-surgery pain is gone as far as the pain in my butt and radiating down in my leg. I still have a lot of lower back pain (not related to the surgery),still have a lot of muscle spasms in my back, and cannot walk any distance at all. I don't know how anyone could call a TLIF a "minimally invasive" surgery! We do all recover differently, but I wish my surgeon had been more realistic in advising me as to the time it takes to recover.

    I had no other option left except the surgery if I wanted to be able to walk. I don't regret doing it, but it has been a long haul.
  • I also had a b/l pars defect/spondy which I've known about for 15 years. I decided to have the surgery when I was no longer able to continue doing my normal activities of daily living which include taking care of my house and acreage. For me the surgery was easy except for one complication that I didn't expect . . . nerve pain. From day one post op my back never hurt, still doesn't even with 6 titanium screws, but my lower leg which was fine pre op has areas of severe burning pain which I take several medications to try and control. I went back to work teaching nursing after 3 weeks (I had to but don't recommend it) took the brace off at 4 weeks and started physical therapy. In between teaching and physical therapy I do take it easy. I also take several vitamin supplements to aid in my healing. I've been off narcotics for a couple weeks now except for one Percocet every now and then before bed. Hopefully my nerve pain will subside and not be a symptom of a greater problem. On another note, my best friend had the same surgery 2 years ago, did beautifully, and actually did some easy snow skiing about 4 months later (not recommending that either). You are doing the right thing by asking questions and beginning to prepare yourself. I wish you the BEST of luck, let us keep hearing from you.
  • Mark,
    I just read your story, and it's the first positive one I've read about fusion surgery. I've had a L5-S1 laminectomy done recently (May 08), and am thinking about a fusion next. I still have leg pain from scar tissue. My orthopedic doc hasn't said for sure he will do it, but it's been discussed some. I may have to make a decision as to whether I live with this S1 nerve pain or try a fusion in hopes of relief.

    I run a daycare, but I don't watch infants, since this is a lot of lifting. I guess I'm hoping you could tell me a little more about your recovery process. How long did you have to be off from work? Were you allowed to squat down to get things or sit on the floor after surgery? (Like a month after surgery?) Were you allowed to do any exercises at all before 6 weeks? Sorry, so many questions. Just hoping to hear about someone else's experience before opting for this type of surgery.

    Hope all is going well for you now.

  • Thank you so much everyone for posting here...i havent looked for a while and it was a pleasant surprize to see so many replies to my question.

    I was feeling decidedly against the surgery thing today, after feeling quite well, even though im now on the sick from work (probably why I feel well) Reading these posts have made me realise that I am doing the right thing by going ahead with it.

    I have whats called dual pathology in my back, and after seeing my surgeon for my pre admission appt, realised that he is under the impression that my spinal fracture area is settled, which it isnt, so I have an appt with him again on te 11th to tell him that both places cause me as much problems, so who knows maybe he will decide to do something about that also.

    Anyway, since my post above, I know a little more about the L5 S1 condition...its a severely degenerate disc with an annular tear and a bulge into the nerves.

    I am going to discuss the L1 fracture site on the 11th, as I am having lots of trouble there. Mostly I feel like my spine cant hold me up, and am overusing the muscles to keep myself up and resulting in pain around my back and under my ribs.

    I will keep you posted on how things progress, by the way I was pencilled in for surgery the 9th Feb, but Im getting alot of work done on my house this month (its a rental, so i have no say in it) and I didnt want to come from hospital to cope with having kitchen and bathroom ripped out, and rewiring...so my surgery is now going to be 5 March 09. I have to be in hospital on 4th

    Keep me updated on your progress, it will be nice to hear the recovery of you all a few steps ahead of me...once again thankyou tc

  • Well, this kind of explains some of my questions I asked under "surgery or no surgery." I'm scared, excited, nervous, unsure, all at once. My doctor hasn't even said he'll do a fusion yet, but it's heading in that direction it seems. His P.A. has talked to me about it somewhat and is hesitant, but it gave me hope... hope I'd like to hang on to.

    Glad to have read this post.

  • I think you are smart to delay the surgery till your home environment is optimal. It is so important to have everything ready so that you can concentrate on healing!
  • Hello everyone! New to the board today. I had L5/S1 spinal fusion 12/04 and like all the other posts, recovery does depend on the individual. I know my fusion didn't completely heal for 15 months after X-rays every 3 months to montitor the bone growth in the "cage". I too was only in the hospital 4 days but it really is important to have someone to help you once you get home cuz believe me, you can't hardly do a thing for yourself! I was at a 10 lb. minimum and did you all know a gallon of milk weighs 7-8 lbs?? I didn't. Walking is very important for recovery also. Now the bad news, I started having nerve pain in my butt and down my left leg in 2006 and a myleogram and CT scan showed a 30% bulging disc at L3/L4. So I've been dealing with this degenerative disc disease pain ever since. I have a low tolerance to pain so I'm on quite a few meds but took myself off the heavy duty ones so I could function during the day! I just had another myleogram and CT scan on 2/3/09 and would you believe it didn't show anything!! Even my Doctor is frustrated so he is ordering to have a facet injection done to see if that works. I didn't know if that was anything like an ephidoral as I've had 5 over the past 5 years and none of them worked for even 1 day! That's how I found this forum. I'm desperate to do something for this pain cuz it really gets to your head and makes you quite bitchy! Sorry for that-I'm hurting right now and need to sign off. Any suggestions, please drop me a message. Thanks for listening! I hope this injection gives me some relief! Have a good evening everyone!
  • Swimming! I suffered alot with back pain for a very long time, especially after i fractured it. When I was mobile enough, I took myself off swimming, struggled into my bathers and swam, properly, not with my head up out of the water, which curves your back backwards....I got out of the pool, changed and when I was walking from the Leisure Centre, something dawned on me - I had no pain, really, none at all! I had changed no problem and hadnt even noticed..when Im well enough after my fusion, thats what Im gonna do, swim!!

    I also love walking, and am glad that its a very good thing to do for recovery, with my back hurting like it does, i get releif from walking if i concentrate on making sure my back muscles are relaxed (they want to be tense all the time, i wont let them) and that i take big long steps, really loosens me up, the stopping and sitting are the problems tho
  • Don't worry about being bitchy. You have every right. It's hard being in pain all the time. People just don't understand that who aren't going through it. They get tired of hearing about it, but we get tired of "living" it!

    I know, even though I'm in pain still, the core exercise called "planks" has helped my back. You mentioned DDD and a bulging disc at 3-4. These exercises are wonderous. But if you do them, ask your physical therapist how to do them the proper way. There are so many ways to do them wrong.

    I'll pray for you.

  • I'm 3 wks post op, whew...its much more difficult than you think or as drs lead you to believe. Mark said it best, "Listen to your body". I'm a runner/traineresque physique. I tried to walk 1/2 mile at 1.5 on treadmill when i was released from the hospital, it was not a good idea. I thought that would be baby steps for me, wrong! Rest, rest, rest....walk around a little then rest again and again. Also, Mark is right, dont think u will get better day by day... you will drive yourself crazy. Judge week by week. Its definitely an emotional roller coaster as well as painful process.
    Hope this helps.
    PS: i had MI TLIF, dont believe the quick recovry times they tell you.
  • A little backround first,

    I was first diagnosed with spondylolisthesis almost 30 years ago as a young paratrooper in the Army. The Docs at the time were more interested in keeping me on my feet and jumping than correcting the problem. Through PT, Physical Therapy, Pain Management, I was able to go my entire career without surgery. After retirement the pain, numbness, weakness in my legs not only became unbearable but also life threatening, I currently work in a copper foundry and the instability has made work too risky, so I decided to go with the surgery to correct the problem.

    I have never had any type of surgery and had no idea what was comming, after talking to the Surgeon, Doctors, Physical Therapists, I thought I was ready and prepared, WRONG !

    I researched all I could, talked to every person that would lend an ear and so on......

    The Surgeon and Docs in the Hospital told me that the surgery would be 1-2 hours long, my stay on the ICU would be 1-3 days, total hospital stay 8-14 Days, Pain after the Surgery would be managed with Anti-inflamatory, Opiate Based Meds.

    Well to make a long story short, the Surgery was 5 hours long, No stay in the ICU, and I walked out of the hospital under my own power 3 days after the surgery, 5 days later I took myself off the opiats.

    Recovery has been slow but every day brings its own little victories, the time on my feet becomes longer and longer, the distance walked further and further, mobility a fraction of an inch more every day, and the pain just a little bit less.

    At the time of writing this I am 14 days Post OP, I have been doing light garden work, take my Lab for long walks, go shopping with the wife, window shopping with my daughter, fix whatever my son breaks, all in all getting back into life.

    Don´t be fooled the going has been slow, I work a little, then take a break, work a little more and take another break, the work has become longer and the breaks shorter, others have already said it but here it is again, Listen to your Body !, but don´t be afraid to push it.
  • Wow Ed Daley, I am truely floored that you could be doing all that you are doing 14 days post op from a l4-5 fusion. I can see things like walking and maybe moving getting a tad better but 14 days and you're doing garden work and driving around with wife and daughter, wheeeeeeewwwww.

    If this isn't spam of some sort, man I'm delighted to see such good progress from this kind of a surgery, similiar to one I face before not too long myself.
  • SpinalguyFLSSpinalguyFL Posts: 1
    edited 12/25/2012 - 10:23 AM
    I first injured my back at 17, and at 22 was shoveling snow and really blew it up. I was told I would need surgery in 5 years, I lasted 23 years until a project at work made everything slip more. I did 2 more years of exercises,therapy and injections and etodolac to try and treat this as a disk issue, it was not. The MRI revealed severe foraminal narrowing and slippage and a tilt to the right at the L5 level. I got MI TLIF and walked out of the hospital 1 hr after a 3plus hour surgery.
    I am 19 days post MI-TLIF and off the Oxycodone four days. I had a near Level 2 spondylolysthesis and they moved my whole spine 1cm back and its visibly straighter now. I was able to walk around the block after a week. However I have the same symptoms as before and that is when walking my lumbar starts to hurt then my right glute tightens up and I start limping. That part is depressing me but when I read about other people needed Morphine I feel better. The PAs and Doctors at the surgery place seem optimistic at my results.
    I think all my expectations are still unrealistic so I will hold off on any complaints. The withdrawal from Oxycodone is lousy as I was depressed 2-3 days including Christmas eve.
    I was hoping to be pain free after 2 weeks but at least its structurally sound.
  • Hello all I'm having a PLDF and TLIF on 5/6/15 and am worried about the recovery and being able to go back to work. I work as a vocational assistant for handicapped adults and it's a very physical demanding job . Realistically will I beable to return to this type of work or should I search for another job within my company?

    Thanks krista
  • hows everyone doing? concerned about my progress
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