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Runner looking for advice on TLIF L5-S1

AnonymousUserAAnonymousUser Posts: 49,622
edited 06/11/2012 - 7:28 AM in Back Surgery and Neck Surgery
Hello,

I am a runner (M, age 43) and for the past 3 years I have experienced consistent problems with my left leg. It wasn't until recently that I was properly diagnosed with Spondylolisthesis grade 1.5 and Spondylolis L5-S1. Before getting the right diagnosis I had many different treatments including, massage therapy, acupuncture, chiro, spinal decompression, epidural injections etc.. Nothing worked to relieve the discomfort down my left leg. My primary issue is that my left hamstring going down to my foot tightens up when I run and feels sore there after. I ice my back on a daily basis to help relieve the discomfort.

Now I will say that my discomfort doesn't seem to compare to some of the posts I have read but none the less it bothers me. If I didn't want to get back to serious running I probably won't pursue surgery. I feel I have found the right doctor if I decide to have the procedure but I want to make sure I understand all the issues before making a decision either way.

So my question is specifically directed to any runners or endurance athletes who have had TLIF done. Can you please tell me if the surgery was a success for you or if not a success why?

I appreciate any feedback to help me make my decision.



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Comments

  • Hello and welcome to the board,

    I would like some additional information before I try to answer some of your questions.

    What distance do you run and what do you intend to do in the future? Does your surgeon have this information?

    Do you know if you have any disc problems?

    Are you seeing an orthopedic spinal specialist or a neurosurgeon?
  • Thanks for replying to my post.

    When I was training for marathons I would run 25-35 miles per week. My surgeon understands what my goals are for returning to running and feels that with this procedure there is no reason why I couldn't return to running longer distances.

    I am seeing a orthopedic spinal specialist. I have a degenerative L5.

    I do not have any back pain all my symptoms are in my left leg.
  • As you were probably told, there really isn't another way to treat spondylolisthesis except for a fusion that will stabilize the area. Your thigh pain is no doubt caused by the L5 nerve. You can check a dermatome chart to see how the nerves innervate which part of the leg and foot.

    My personal belief is that most surgeons are a tad on the optimistic side when handing out advice about what a patient will be able to do after surgery. They are quick to say you'll be able to do anything, and I guess that is the case for some.

    There are many things to weigh when deciding to proceed with fusion. Since it is almost always an elective surgery, only you can make the decision. I would encourage you to do your research. Read all you can on your condition. Research your choice of a specialist and be sure to get several opinions.

    If you decide to proceed with surgery, go in with the attitude that you will need to be patient with your recovery. You will not want to rush the process and you will want to know that it takes time to heal and for the compressed nerve to recover. This is not a six week time frame. It takes much longer than any of us think it should.

    If everything goes well, your back should be as strong as ever and you should be able to continue to run.

    You might want to ask your surgeon about doing a 360 degree fusion. This would provide the maximum amount of stability. Find out if this procedure would provide any additional benefits that you cannot get from a TLIF.
  • The TLIF has complications/morbidity/scar tissue and long recovery, not to mention more surgery will probably be nessasary, I believe it is better, or the only procedure for upper lumbar region, A new procedure called axiaLIF is being used for the L5-S1 segment, is is the least invasive procedure available, I also have spondylolisthesis grade 1.5 unstable. I would no longer consider the TLIF now that the AxiaLIF is FDA approved. I suggest you find a great neurosergeon who has good experience with the axiaLIF {Trans1} procedure. You will thank your lucky stars you found the right approach, walk out of the 45min.surgery with under a 1 inch incision and expect a fast, complete recovery, Its the absolute best fix if your considering a fusion. I am scheduled at Christ Hos/Cincinnati OH the end of April...... Go to Trans1 website to find a local Neurosurgeon. Kick your orthopedic surgeon to the curb. Let me know what state you are in. Good Luck. Brian
  • If you're having a fusion, I'm thinking it's probably going to be longer than 3 months before you can run. I've had a three-level and have been told that I can't run anymore. Nor and I ride a bike or a horse. I also had allograph with BMP mixed with my own bone marrow. It seems to be fusing well. You're a lot younger than I am and only have one level, so hopefully, you'll do great. You want to be totally sure you're fused before you jar that joint much, or you'll just be facing more problems. Perhaps it's time to take up a new sport?

    Linda

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • It all depends on how you recover. I used to run half marathons and 5ks. I did 25 miles a week. I have no hope of ever running again and I had the L5/S1 fusion. I am getting better--but I would never EVER risk running--the pounding--it just isn't going to be an option. I am 4 months in--I could run today if I wanted to--it would hurt like crazy--but I could physically do the deed. However, I am now considering the elliptical, the bike, the water, etc.

    If you are still able to run--I would question whether or not you are truly ready for this surgery. I've also heard good things about the Axialif, but it is also minimally invasive, which means the surgeon does not have great access to the actual spine. He or she literally does the fusion through a tube inserted through the tailbone--I've seen one online. With the open back surgery, the surgeon, for better or worse, has full access to see the spine. Be careful...

    Chuck
  • Chuck, you think open back is better because the surgeon has you wide open, cuts muscle, pulls tendons/ligaments, and inflicts trauma on nerves, then attempts a partial fusion from only the back side, sure you cant run, it might break, sure scare tissue will form and impinge the nerves, expect re-surgery, continued pain, and drug dependency and forget about sports...."Full access" Barbaric & horrific
    This new advanced technic even available for low lumbar two level fusions, is the absolute least minimally invasive! Axialif L4/L5-S1 you get a full percutanious 360" fusion with a titanium stud thru the middle of it all, Forget about all of the above complications, and get back in the game.
    I am sure many who had the tridational fusion in the past, would have rather had this approach. It is used to repair failed fusions too, Time and innovation marches on!
  • I had a tlif fusion 19 days ago for L5/S1 and i feel great! im not on any painkillers at all, and started driving yesterday.

    I didnt get a brace, or any walking aids and have no restrictions except the blt thing, which ive imposed on myself to be honest...i start physio tomorrow, and ive been walking all sorts of places since getting home from hospital, it started with round the block and is now up to mountain trails and the beach and cliffs round where i live. My partner been putting me in his car and finding good places to walk with me.

    I am fit, as ive worked outdoors a long time with horses, and walked daily with my dogs for years, so i suppose my recovery is faster...i am 37 years old. I even asked my partner if he could walk a bit faster at the supermarket yesterday...heehee.

    True the first week was terrible, with allergy to morphine and most other good painkillers, and really bad nerve pain down my legs, and getting stuck in one position in the bed and chair, but now, even though still sore (i use my soreness to guide me when to rest, hence the no painkillers, also im not very good at tolerating them) im doing really well.

    If your a runner, then your fit, and if your fit you will recover quicker...my attitude is, why wait until the pain is so bad you have to stop running, pile on weight and then take far longer to heal...seriously i found this operation far less of a deal than i thought.

  • Pianotek--

    Totally agree--I was just presenting the other side. I wish I had done more due dilligence on the Axilif, but I just ran out of steam. The argument I heard FOR the open back surgery is that the doctor has a better chance of accurately addressing the diseased segments. The open back surgeries today are much less invasive then they used to be, if that is any consolation. I have been told I may need a posterior approach to supplement my anterior (open) approach, at L5/S1.

    Chuck
  • shazza said:
    I had a tlif fusion 19 days ago for L5/S1 and i feel great! im not on any painkillers at all, and started driving yesterday.

    I didnt get a brace, or any walking aids and have no restrictions except the blt thing, which ive imposed on myself to be honest...i start physio tomorrow, and ive been walking all sorts of places since getting home from hospital, it started with round the block and is now up to mountain trails and the beach and cliffs round where i live. My partner been putting me in his car and finding good places to walk with me.

    I am fit, as ive worked outdoors a long time with horses, and walked daily with my dogs for years, so i suppose my recovery is faster...i am 37 years old. I even asked my partner if he could walk a bit faster at the supermarket yesterday...heehee.

    True the first week was terrible, with allergy to morphine and most other good painkillers, and really bad nerve pain down my legs, and getting stuck in one position in the bed and chair, but now, even though still sore (i use my soreness to guide me when to rest, hence the no painkillers, also im not very good at tolerating them) im doing really well.

    If your a runner, then your fit, and if your fit you will recover quicker...my attitude is, why wait until the pain is so bad you have to stop running, pile on weight and then take far longer to heal...seriously i found this operation far less of a deal than i thought.

    AHHHHHHHHHH!!!!!!!!!! I'm green with envy!! This is what I was hoping for when I had this surgery done! Seriously, I'm happy for you--that is great. I was also physically fit, 36, non smoker....still in pain. I was also on a lot of pain killers and am weaning way down, so maybe, just maybe...I just can't imagine the pounding of running being a responsible choice for post-fusion--however, I'm the wrong guy to ask...I also developed blood clots to my lungs post-surgery.
  • Anonymous said:
    Hello,

    I am a runner (M, age 43) and for the past 3 years I have experienced consistent problems with my left leg. It wasn't until recently that I was properly diagnosed with Spondylolisthesis grade 1.5 and Spondylolis L5-S1. Before getting the right diagnosis I had many different treatments including, massage therapy, acupuncture, chiro, spinal decompression, epidural injections etc.. Nothing worked to relieve the discomfort down my left leg. My primary issue is that my left hamstring going down to my foot tightens up when I run and feels sore there after. I ice my back on a daily basis to help relieve the discomfort.

    Now I will say that my discomfort doesn't seem to compare to some of the posts I have read but none the less it bothers me. If I didn't want to get back to serious running I probably won't pursue surgery. I feel I have found the right doctor if I decide to have the procedure but I want to make sure I understand all the issues before making a decision either way.

    So my question is specifically directed to any runners or endurance athletes who have had TLIF done. Can you please tell me if the surgery was a success for you or if not a success why?

    I appreciate any feedback to help me make my decision.



  • I had this procedure done and began walking immediately. By December 31, I walked six miles. At about three months,ran my first mile. It's nine months and I reached six miles. Mixing cycling and running seems to work well. Days when the run doesn't go right I scrape it, walk and stretch. The range of motion has changed. The mindset is to adapt.
    I'm a male 55yrs old who completed thirty-three marathons,feel I have a few left.
  • Pianotek:

    Sound like sales pitches. do you have experience with this procedure or work for the company?

    angela
  • Can you please tell me who your Dr. is. I am about to have this and my last fusion I have never recovered from
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