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Questions about Spinal Fusion

angela_talley03aangela_talley03 Posts: 110
edited 06/11/2012 - 8:29 AM in Back Surgery and Neck Surgery
Hi everyone,

I will be having a anter/posterior lumbar spinal fusion on April 1, 2009... And I was wondering about how long the surgery takes.. I know that they are different for everyone, but I was just hopeing to at least get an idea.. I have not had my pre-op appointment yet and will be able to ask the Dr. when I do, but for now I am just very nerveous and would like to have a little knowledge before hand.. :SS .. Also could you tell me about your first night after surgery... I am trying to get a good grip on everything.. I want to know what I'm facing when the surgery is over.. Thank you so much in advance... Good luck to everyone...

P.s. Also could you tell me the difference with using my bone or donor bone for my graph....

24 years old
16 days until 360 Lumbar spinal fusion


  • Angela,

    I had a L4-S1 posterior fusion 6 weeks ago, the 1st 24 hours I was high as a kite on morphine. I remember moving and bleeding everywhere which made me a little cautious, things were kind of a blur.

    I was in hospital from Tuesday to Sunday and they had me walking around on the Wednesday, they encouraged me to perch on my bed to eat and also walk around by myself after a couple of days. I didn't really do this too much, it kind of felt like I had a coat hanger in the middle of my back if that makes sense? Felt like I needed a good stretch.

    By the Friday I was more comfortable and was walking up and down stairs, I also practiced walking to the exit, I was in a room next to the operating theatre which happened to be a mega long walk to the exit. I managed OK on the Sunday, getting into the car was an experience and I certainly felt every bump on the way home, getting out of the car wasn't so bad.

    I have reached little milestones in my recovery e.g. having the staples removed after 10 days, I had a bad skin reaction to the glue they use to keep the surgical dressings in place when they operate, this caused my skin to burn and peel (the pain from this was more uncomfortable than the post-op pain), at the weekend I managed to shower, dry and dress myself, I am also able to drive again now.

    With regard the bone graft, some of my own was taken from my hip, supposed to have a higher rate of making the graft take, I have had no pain from this at all.

    My back continued to feel tight as it healed, this was one of my major problems, within a couple of days of the last scab falling from my scar my movement felt a lot more loose.

    I am now walking 6 miles a day, my muscles are aching from walking differently and standing so much, I wasn't really very active before my operation.

    In my case the post-operative pain has been nothing compared to the pain I had before surgery. Obviously your surgery is slightly different, but I do have a humdinger of a scar on my back now!

    Picture of my scar before I had the staples removed and you can just see the start of my skin reaction to the glue.


    Good luck!

  • Firstly nerves are very common right now, so try to keep calm and your doing the right thing by asking questions. Keep in mind however that we can only offer our own expereinces and I think you know that by reading your post. There is a great post on here called "post op must haves" or something like that up at the top and there are great suggestions as things you will want to get to make recovery easier in the first few weeks.
    My own experience, I had L4 to S1 done three months ago, it was PLIF so they didnt go through my stomach at all. The surgery was about two hours long and I was outpatient so I dont have much in the way of experience on the hospital stay except for the recovery room. I knew I was in pain after surgery and if felt like a deep bruise and ache, almost like a bad shin splint if you have ever experienced those. My pain was well managed before I left that same night, and I slept relatively well, and was able to get to the bathroom on my own (but needed help getting pants down and up). The first week was unpleasant, I had the most difficulties with moving my hips while seated to standing and moving them on my own while laying down. That subsided after two weeks and I noticed I was getting more strength back. I was off pain meds at the end of the second week and in physical therapy at week three which for me has done a world of good. The best advice anyone and everyone gives on here is to not over do it in the first eight weeks you will be on restrictions, FOLLOW THEM and dont compromise your surgery to bend lift or twist. This is a long recovery process, so do as your doctor advises with your restrictions its so important. I am three months out and just now finding that things are getting a bit easier. Patience is vital at first and remember you have us here to help support you and understand what you are going through. The scary part is almost here, and almost over. Anticipation is a really good source of anxiety, but you will be okay and soon you will be on the other side telling someone else how your surgery went. Keep your chin up, take a look at that post and Im sure more people here will respond and give you there experience. Best of wishes on your upcoming surgery and keep us posted when you can on how you are doing.
  • My nerves are fried and I'm in so much pain. My husband has asked me not to read everything I can find about surgery, but I have to research.

    Thank goodness for this forum...now this post is causing me to have additional questions....

    My surgery will be soon...I hope...ins. has finally rescinded their refusal....Thank God.

    My surgery is to be posterior. Decompression and PLIF at two levels, L4-5 and L5-S1.

    The surgery will be performed 4 hours away from our home.
    My husband will be staying in our camper that is pulled with his truck. My questions:
    1. Will the ride home after approx. 4 days in hosp. be possible?
    2. Staples....will I have to make a trip back 4 hrs each direction to have staples removed in approx 10 days????
    3. Can I stay alone at home after I finally get home?
    4. I am a healthy lady ( other than this and need for neck surgery in approx. 8 months )so do I have reasonable fears?
    5. Walking 6 mi. per day....is that on a treadmill? Are you losing massive amounts of weight?

    Last two trips to grocery store have been so painful. Had to hold on to buggy and had to have assistance taking groc. to car and getting them out at home. I can tell daily that I am getting worse and the pains are increasing massively recently.

    Thank you
  • Angela,

    I had a single-level fusion done last August. My surgeon used facet bolts and it took 1.5 hours. If he had used rods and screws, it probably would have taken 2.5-3 hours.

    My surgery was done first thing on a Monday morning and I was home Wednesday afternoon.

    For me, the worst part of the first night was nurses waking me up every 1.5-3 hours. Other than that, I was pretty tired and the morphine also helped a bit. On Tuesday morning, the morphine stopped working and I was in a good amount of pain until they put me on oral meds. An hour later and I was doing fairly well again.

    Good luck with your surgery.
  • Barney,

    1. In my opinion the ride home will be very uncomfortable, I reclined my seat and the journey was only 15 minutes, then again the only pain meds I was using was over the counter type headache tablets (paracetomol in the UK, not sure what your equivalent is, maybe Tylenol?).

    2. A nurse cam to my house to remove the staples, not sure if that is available in the USA

    3. As long as you make plans then you should be OK alone, food needs to be prepared in advance for you, everything at waist height that you need etc

    4. Any fears about surgery are understandable, I even wrote a letter to my wife in case it went severely wrong and I didn't wake up!

    5. I am varying between the treadmill and outdoor walking, the treadmill is easier than outdoors as there is uneven ground etc outside

    Good luck with your op, I am sure things will go well.
  • Hi Angela, you will find there is a lot of variation in lengths of surgery for fusions. I have read of a 360 only taking 2 1/2 hours for a member here. Then there are people like me, who had only 1 level PLIF and it was 5 hours. My neurosurgeon said 5-7 hours due to dissection of nerves. He is very meticulous and I woke with zero nerve symptoms, which I believe is due to his technique.

    I had bone from my lamina and spinous processes along with bmp. My surgeon no longer does hip grafts due to pain and requiring a second surgical site.

    Hospital stays vary widely as well. I spent 5 nights in the hospital. The first night I had a dilaudid PCA which kept the pain under control. I couldn't sleep at all that night. The nurses came in to turn me every 2 hours. I was nauseated and got some good meds for that. I had a catheter for about 24 hours, and it was awesome, cause once they took it out, getting in and out of bed was very difficult. Beware of constipation, it is the worst after spine surgery. Take any stool softeners or other laxatives they offer you.

    Nerves are normal right now. Surgery is very scarey, but you will get through just like the rest of us. Try to get as prepared as you can. Read the post-op must haves list and get your home ready. I took some xanax to get through the week before surgery. Kept having second thoughts out of fear. But now I am so glad I went through with it. I am doing great and fusing nicely.

    Good luck with your surgery, you have found a great place for info and support. >:D< Cali-Sue
  • You are so wonderful to give all this good advice. I can't take most pain meds....so that is going to be a problem also. Codeine and morphine really give me tons of problems, i.e. vomiting, hives, etc.

    I am definitely going to call my PCP to see if he will give me some nerve meds and phenegran to take now and later.

    My Neuro is very highly thought of and I respect him....just the more time you have to think about it, the more time for worry. I've known since mid Jan. that the surgery was necessary, but ins. denied approval and just a couple days ago approved.

    So, here I am, reading and learning from all of you and I genuinely appreciate your information.

  • Thank you guys so much for the stories... I really feel better hearing from someone that has been through the pain and says it was not like death... Ha ha ha ha... I think I have to keep telling myself that I have to listen about the bending because I have a baby and I always want to pick her up... Well I called my Dr's office and they said that he will be taking the bone from my hip.. So there goes another cut to heal from... So I will have the front, back, and hip; and they will be using screws (4 of them) and little rods about an inch or so long... Just long enough to go from L4 to L5 (The back half of my vertebra is broke completely off the front.. It's right where it connects around my spinal cord on both sides)... I'm just so ready for this to be over with and the healing to begin.. Within the past year I have had a c-section, tumor removed, and now this which started in Nov... I'm just ready for life to be back to normal... But I really believe that this will be much easier with the help of this site.. So once again thank you guys and I hope everything goes well with your stuff.....

    24 years old
    16 days until my 360 lumbar Spinal Fusion
  • Angela,

    I don't really even remember the first few days. Apparently I lost a lot of blood, and I need 3 units of blood. My boyfriend and kids said I was moaning in pain most of the time. I was not allowed out of bed for the first 3 days due to vomiting and too much pain meds - apparently I'm allergic to fentanyl.....

    Anyway, I don't mean to scare you, this was just my experience, and I want you to see that everyone has different experiences and different issues. I am sure you will do fine!!
  • Angela,

    I don't really even remember the first few days. Apparently I lost a lot of blood, and I need 3 units of blood. My boyfriend and kids said I was moaning in pain most of the time. I was not allowed out of bed for the first 3 days due to vomiting and too much pain meds - apparently I'm allergic to fentanyl.....

    Anyway, I don't mean to scare you, this was just my experience, and I want you to see that everyone has different experiences and different issues. I am sure you will do fine!!
  • I had a two level fusion and discectomy in Dec. I was also 4 hours away from home. The drive wasnt pleasent but my Dr gave me a shot if diadud for the ride home. I also reclined and that helped. Also take a plastic garbage bag and put it on the seat of car and it will let you slide in and out without twisting. The first day is the worst, but the Dr will give you plenty of meds to make you confotable. I have been on alot of pain meds for 2 + years and they were able to control my pain. Just tell the Dr you are concerned about it. You will probably have a catheter, which is normal for fist day or so. Not bad. First time up is worst, then it gets better. I was in hosp from thurs to tues. I am still on pain meds, but feel that i am doing fine due to the fact that I had 3 torn discs giving me lots of pain. You will be fine. Good Luck and PM me if you have any specific ?. My surgery was long almost 8 hours.
  • Angela,

    They managed to take the bone from my hip from the one incision on my back, you never know they may be able to do this with you.

  • Hi -

    I had anterior/posterior L4/5 at the end of July 2008. My doctor did the anterior on Monday and the posterior on Wednesday - and I don't remember now how long each took.

    I don't remember much about the 1.5 days between the surgeries. However, on Wed after the posterior the nurses had me up and walking in the afternoon. It felt great to move a bit though I was tired and weak. My pain was well-controlled in the hospital with IV drugs - not morphine as I am allergic but Valium helped the most as it controlled the muscle spasms that seemed to be the biggest pain issue for me. They sent me home on Friday with hydrocodone and valium - I only took a minimal amount because they make me feel awful (I am really sensitive to meds) and discontinued them completely after a couple of weeks.

    For the first couple of weeks at home you will want someone with you most of the time. As someone else mentionned, the list of post-op must-haves is really helpful. Prepare your house so that things you need are where you don't have to reach or bend to get to them. And have lots of things to distract and entertain you for several weeks so you can rest and recover. It really helps as the recovery is long and gets boring - patience is the key. There is lots of recovery info on this site that is very helpful.

    Good luck with your surgery!

  • Can anyone tell me how long it takes before you're able to squat down to pick things up after fusion? If you keep your back straight, is this possible after a few weeks?

  • dilaurodilauro ConnecticutPosts: 9,859
    will go by pretty quickly. As others have said here, you will be on a good amount of pain medications, so part of your hospital stay will be a blur.

    When it really matters, is when you come home. Thats the beginning of your next phase. You have been through the pre-phase , which is identifying the problem, isolating it, working to fix it and then making the decision for surgery.
    The next phase, the surgical piece is something that normally is out of your control. You can do your best by selecting a surgeon you are comfortable with and has experience with your type of surgeries. It is also so important to know the Hospital you are having the surgery done in. Inquire about the staffing. Your surgeon is only one piece of the entire process. You have all the supporting staff that is in with you during surgery and then when you are up in your room, the nursing staff and others that will be looking after you. You might see your doctor once or twice while you are in there, but you will be seeing your nurses a lot. I would find out the floor that you will have your bed in and the nursing staff that provides the support.
    Then the next phase is your recovery phase. This is when its all up to you. You will get the Physical Therapy, the instructions, etc. But bottom line, its in your hands.
    The most important piece of recovery is making sure that you adhere to all the limits and restrictions that your doctor gave you and never over doing anything. Recovery takes time, have patience... You will have some good days and you will have some miserable days. Wish that wasnt so, but its reality.
    Always remain positive and strong. Let the doctors do their work and then you do your piece.
    Thats how down the road, you will be able to do many of the things you did before and without pain.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I had my 360 at L4/L5 with an ADR 4 months ago. My surgery was just over 2 hours and I woke up with some pain but the recovery room nurse took care of that. I was up walking that afternoon. The first walk was just a couple of rooms away but they said that was great. As the day/night went on I was making laps around the hospital floor getting more comfortable each time. Pain control was good but it is tough to sleep you have nurses coming in to check on you. I appreciated the nurses, really they were great it is just hard to sleep.

    I went home the next morning after a shot of something in my IV. I was fine for my 20 minute ride home and was happy to be home and in my own bed. The first day is the worst and it does get better every day after. Take it easy and try to have someone stay with you for a couple days. I also had bone marrow aspiration from my illiac crest to use in the fusion and had no issues with that healing just fine.

    I know the road is long but I feel great now. I have no back pain and I am medication free and back to work. I wish the same for you and best wishes to a speedy recovery.
  • I can't thank you guys enough for all of your input.. I thought that I would get to see my Dr. at my pre-op appointment but called to make sure and was told that I won't.. I will see some other Dr's to do my EKG and so forth.. So I made an appointment to see and speak with him Thursday.. I have started my list of questions already.. But I still don't think his answers can help me as much as hearing what you guys have already been through.. My surgery will be in Houston and I live about and hour and 45 minutes away(with no traffic) so I was wondering if anyone had to make a drive that long after their surgery.. I am trying to figure out if I should just ask for a very good shot of some kind of pain meds to get me through the trip or if I should try to break it up and drive a little and get a room and finish my trip the next day... I really don't want to stay at a hotel... I know I will want to be in my own bed back with my babies more than anything... My plan is to have pillows and to sit in the back of our truck which is very roomy and I can recline the seats so I can be as comfortable as possible... So having already been through this, what do you guys think.. I hope everyone has a great and pain free day... Thanks in advance...
  • I think you'll be able to get home OK after your surgery. Your pain will be controlled by oral medications before they let you leave the hospital. Be sure to plan at least one stop on the way home to get out to walk a little bit. You don't want to risk a blood clot. Even once back home, it is a good idea to get up and stretch, walk around a bit every hour or so. You won't want to sit for more than 15-20 minutes at a time in the beginning. But I'm sure your doctor will give you instructions and you should follow his directions rather than what we say!! (at least in this case!)

    I'm pretty sure there are people on here who had a longer drive after fusion. I think you will be fine. If you have a choice between a curvy road and a straight one, have your husband take the straight one -- same goes for a bumpy road...and ask him to drive as smoothly as possible. Just the natural acceleration of the vehicle will cause your muscles to brace in an attempt to keep you supported...so as smooth as possible with help.

    Are they doing all your surgery at one time?
  • It's a striaght shot on the interstate so at least the roads are good.. I think I'm more worried about everyone else's driving rather than my husband's... And yes I will be having everything done all at one time.. I was not even aware that there was an option to do it at different times... But I think I would rather just get it done and over with...

    Only 14 days until my 360 Lumbar Spinal Fusion
  • It's a striaght shot on the interstate so at least the roads are good.. I think I'm more worried about everyone else's driving rather than my husband's... And yes I will be having everything done all at one time.. I was not even aware that there was an option to do it at different times... But I think I would rather just get it done and over with...

    Only 14 days until my 360 Lumbar Spinal Fusion
  • I had a four hour drive home, during a snow storm cause my ins co wouldnt let me stay another day. It was fine. They gave me a shot before I left for the ride home. I reclined and was fine. I do suggest you take a big garbage bag to put on seat. Makes it easier to slide in and out of seat so you dont twist. Pillows are good, but I am sure you will be fine. If you have to get in a pick up,, have hubby bring a stool for you to step up on to get in. Long way up there when you have had surgery, and I still use it when we take our pick up. Just a small one, helps so you dont strain. Let me know if there are any other questions, I can help you with.
  • Now see I would have never thought about that.. That's why I love this place... I know I'll be thanking you times a million when I'm getting in the truck without to much pain...

    14 days until my 360 Lumbar Spinal Fusion
  • It is handy and you can throw it in the back. No way could I have got in with out it! Make sure you have a cane and walker. I know you feel like grandma grunt, but it helps!LOL
  • A walker with roller wheels and brakes are great for walks outside until you feel stable.
  • I'm still trying to learn all the abbr. on here.. What is a bmp.. Was your surgery suppose to last as long as it did.. Did you get sick from being put to sleep that long....
  • BMP is the stuff they put with the bone that is supposed to help you fuse better, quicker, and increase your odds of sucess. If you google it, it will explain. But ii is a protien that is pretty controversial here. My surgeon uses it with no problems and since I have had 7 surgerys in 16 months, I needed everything I could have to increase my odds.My surgery was only supposed to be 4 hours.I had a sacral tumor that he also had to check out. But I dont know why it took so long. I really should ask. I didnt have any blood transfusion or anything. I just think it took a long time with two levels and replacing discs and then the tumor. And I am so senitive to ansethssia, (sp) that I always tell the anst. Dr that I get very sick. They always give me something for nausea. Not a problem. Also, I was on so much pain meds prior to surgery, that I was worried about pain control after. But they did very well at controlling my pain level. So well, I dont really remember the first couple days much.Lol If you have a touchy stomache let them know prior to going in. And when you get back to O.R. remind them. You will do fine. I am 48 and have dealt with this for 2 1/2 years before surgeery, so I am hoping that since you are so much younger, you will snap back alot faster. Just know, that you need to measure your progress from Dr visit to Dr visit,.Or it will drive you nuts. You can remember how it was the last visit and see that you have done better. Any other questions, please ask away. I know how nervous you must be. I remember it well..
  • Hi Angela, so glad you are finding this forum helpful. Just to elaborate, BMP is bone morphogenic protein. It is an artificially created substance that is a replica of a natural protein in our bodies that helps facilitate bone growth. It is approved for use in anterior lumbar fusion with the Infuse/LT cage system. Many surgeons are using it off-label in posterior and other fusions using different cage systems. It is controversial because there have been some cases of boney overgrowth creating new problems in patients whose surgeons used it. It also has been used in cervical fusion with some horrific side effects. You will read stories here on both sides. My surgeon used it with my PEEk cage in my posterior fusion. So far, so good.

    As for the hip graft site, it is commonly accessed through your posterior incision, but it is a seperate area of potential discomfort since some bone is removed from your iliac crest. This is often thought of as the gold standard in grafts, as it is your own bone, compared to cadaver bone or BMP.

    It is a great idea to make that list and take it with you to the surgeon. I always took my list of questions and jotted down answers as he gave them, so I could review it later. I think he dreaded me coming in cause I would always bring my pink notebook with 20-30 questions, LOL. Last visit, I didn't even bring it. Things are looking up!

    Did you find the must-haves list? It is a great reference. Keep in mind you won't need it all, but it gives you a lot of great ideas. I would say the number one necessity is a GRABBER! Or two :))( You just have to follow all your restrictions, as you only get one shot to do this right. You are going to need help with your baby for sure. The weight limit is often 5 pounds and no bending, lifting, or twisting allowed. Will you have a brace? I did, and I think it is a good reminder not to bend, etc. I had a hard tortoise-shell brace for 10 weeks. All surgeons are different and some don't require them.

    Well take care and good luck, >:D< Cali-Sue
  • I am still home, mostly still in bed from Feb 9th surgery. My first surgery went well, and as soon as I woke up, I felt substantial relief. A few years later, I had my second surgery. The symptoms before my first surgery were all in my back. The symptoms before the second surgery were in my back and legs, and were excruciating. The first two surgeries were L5-S1 lamenectomies. The scar tissue from the first surgery had wrapped around my nerves like vines. Therefore every time I moved, they tightened, and it was unbelievable. For the third surgery, there was leakage from the disc, and the doctor told me that there was still some liquid left in the disc, and I would have probable had to have another surgery if he had only done a lamenectomy again. The pain before the third surgery was not as bad as before the third, but I knew it could get worse very quickly. Before the second surgery, I went from walking fine, to only being able to walk short distances, with a cane, in a week. When I scheduled the second surgery, I did not have it done right away. I saw the doctor on a Tuesday, and had him schedule it for the following Thursday, instead of that Thursday. That was a HUGE mistake. I was in so much pain; I wished someone would just shoot me. But, like the first time, I woke up from surgery, and the pain was gone. I can tell you the pain after the third was more than what it was before the surgery. It has taken about 3 weeks to get full, but careful movement to return. From my standpoint, you will have to determine if you can live with your current pain, and deal with the fact that you may wake up one day, and it is worse, and as the day progresses it does not get any better. How my pain started for the third one, was a Charlie Horse in my lower left leg that would not go away. When it started, I thought maybe it would take a day or two to go away, but it never did. Now all my leg pain is gone, but there is still some lower back pain and stiffness. Especially when I wake up in the morning.
  • noticed this question, about how soon your allowed to squat, ive not been told i shouldnt, and have been squatting to pick things up for about 4 days now, and im 2 weeks after my fusion today, so ive been doing it since 10 days post op.

    why is it a problem?

    worried now that i shouldnt have been doing it
  • Well I have my appointment today at 5:15 to talk with my Dr. about my surgery.. Thank goodness... I am hoping that having all my questions answered will help me start getting use to everything... But knowing me I'll think of 20 new questions as soon as I leave his office... Ha ha ha.. You guys have been so great, and I can't thank you enough... When I get back I hope to be able to tell you more.... But please feel free to tell me your surgery stories if you haven't already....
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