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New here. Questions about ALIF

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:29 AM in Back Surgery and Neck Surgery
31 male, previous l5-s1 microdiscectomy.

need fusion on l4-l5 and l5-s1. my surgeon has recommended ALIF with Synfix cage and BMP

Just looking for feedback, recommendations, what to expect, etc.

hoping for good news.


  • Well, that is one way to go about it! Are you at the beginning of the process or have you tried conservative methods first? Have you or are you planning on getting at least one other opinion? Have you checked out this surgeon thoroughly and do you feel comfortable with him/her? And, are you convinced you need a fusion?

    As you know, it is a BIG surgery, one to not enter into without a great deal of soul searching and consideration, particularly due to your age.

    That being said, if you feel comfortable that you have explored all your options, and are comfortable with your surgeon, then you have a decision to make. Each surgeon has a preferred way of doing a fusion based on where he was trained, how he has been influenced by the various companies that manufacture the hardware, etc. If your surgeon has had good luck with the Synfix system, and you trust your surgeon, then that is the system you go with.

    You can run a search on this board to read hundreds of posts pertaining to fusion surgery in general. Just be aware that it is a bigger surgery than the microdiscectomy that you had previously. It would be the difference between having your teeth cleaned and having two root canals. It is a long recovery...often longer than what the surgeon tells you!

    But if it is needed, you go for it!

  • I have tried two ESI's with no relief. I was sent to PT which caused increased numbness in my leg and foot. I then tried traction for 4 weeks and had very little (and temporary) relief. My doctor told me I could try a chiropractor, but he recommended I sit down with a surgeon.

    I found a surgeon that came highly recommended (by both a patient and a MD friend). He explained that most of my problems are with l5-s1. The disc is herniated and there is a build up of scar tissue from the micro. My MRI also shows that the disc has begun to collapse. I also have a bulge on l4-l5. I was given two options. Another discectomy or fusion.

    I'm just worried, that with another discectomy, I will be back in the same position in a couple of years.
  • Have you considered an artificial disc replacement for L5/S1? It would provide more options than fusion does if you are a candidate. I am getting ready for a hybrid surgery but am talking to the Dr about a 2-level ADR now...
  • I have a similar situation (read my signature) and elected to do the ALIF after 13 months of conservative treatment. I was able to return to work in 8 weeks, and I feel good these days (except soreness around the incision). No regrets, but it is a tougher surgery to recover from then the micro d. My L4-L5 is also bulging, I fear I may need surgery down the road but will cross that bridge if needed. I considered ADR but my insurance would not cover it.

    Its a big decision, and IMO, surgery should be a last resort. No two situations / surgeries / outcomes are the same, but for me it changed my life.
  • when you need the surgery. I had it last year, same level. Do I regret it? No. Am I pain free? Not even close. Would I do it over? Yes. When you find yourself "losing" half your life to pain, or waking up in the middle of the might in pain, its time. Others may have it done sooner, but if you have exhausted all other options, and the surgeon feels the time is right, do it. There are plenty of success stories, just appreciate it is major, life-altering surgery. There is a chance you may feel worse after than before.

    On the issue of ADR vs. fusion, for L5-S1 most surgeons will recommend fusion because a solid fusion of L5-S1 doesn't cause a significant loss of mobility and in fact may increase spine stability; whereas two level is more controversial.
  • After years of pain, I finally found a good doctor who works with the SynFix-LR system. The procedure was performed on 12/1/09 on my L5-S1.

    Recovery was going very well up until 16 days post-op where I developed a pain in my left butt cheek that ran down to my left calf. Called the doctor at which point they prescribed me Medrol 4Mg which is a steroid system. Just started that yesterday so still to early to tell but I hope it works. Other than that, I have some good ache where the device was installed but that's been handled pretty well by the pain meds. Muscle spasms were pretty tough the first week but again, meds helped with that. Constipation was a HUGE issue. Make sure you have a game plan for that.

    First few days after surgery, the incision is what hurt the most but that went away for me after about a week. My biggest fear was sneezing and coughing!!

    From a mental stand point, be prepared for some tough days...especially after the surgery. You'll second guess yourself ALOT for going through with it but remember that IT DOES GET BETTER!!!

    This is my first major surgery so I can't really compare it to much else but I feel as things are giong well and look forward to a pain free back and more importantly a pain free life!!!
  • I'm new to this forum, and your post is interesting, personally, because it's been recommended to me to have the synfix on L5-S1 (that's the last disc, right?). I don't suffer a lot of pain in day to day activities, though, it's mainly just in the morning or after any labor (i.e. shoveling driveway), but I run a lot, or did run, like multiple marathons a year. That's when my back REALLY bothers me. I'm only 31. I was hoping that there's a chance I can run hard again. Do you know if there's any hope?
  • I had ALIF NOV 1 st 2010 and i can say that i would do it again!....I had numbness and tigngles and feel like fire in both legs i can now say its only in one leg and the pain is down from 100% of the time to 50% of the time so its a relief and anything that will take my pain from a 10 to a 6-7 i will do! the recovery isn't easy the 1 st few weeks not gonna lie is the toughest thing i've done! and im a mother of 3! but they will keep you well medicated and if i can tell you anything at all is to WALK WALK WALK! even lil bit up and down hall when ya get up to use restroom any lil bit will help! sitting 10-15 at a time is all i could do 1st month. Take it easy and it will all come together everyone is diff but id do it again and if ya need to know anything else where all here and ill tell you staright frw no bs what its like best of luck
  • Oh My God I have one of the best doctors in the spinal surgery business there is NO doubt about that.

    I had surgery April 28, 2011 my legs stopped hurting immediately but the pain everywhere else was very severe to put it mildly now on my second month it has become a complete NIGHTMARE there are no words for what is happening to me. I can be walking two or three feet and suddenly it will feel like i am having a knife buried in my back. And i collapse in so much pain! I can take loads of pain but not this pain, sleeping is one very very scary thing I will wake in very serious pain for SURE every time.

    Now I cannot get my surgeoun to listen to me it's one excuse after another with whats causing the pain this must stop asap it scares me the pain is so bad i wont be able to take it much longer it has the ability to make me do unthinkable things when I go back on the 28th of this month he must do something or i must find another doctor but none want to touch you after go back to your surgeoun I HAVE TRIED!!!

    DO NOT HAVE THIS SURGERY!!! I thought i was bad before surgery thats nothing compared to where i am now OH MY GOD HELP ME!!!!
  • Yes the L5 is the last one then onto the S
  • If its become a problem,maybe you should be going to accident & emmergancy,constant stabbing pain may mean you have herniated or something.I know of a person in New Zealand.He was in the waiting list for a fusion approval & had a type of seisure .He went to accident & emmergancy & was operated on immediately.He was a complete success & hasn't looked back.I think the public system is probably still fighting insurance company for the costs ,LOL.
    Don't let it be life threatening dude.
  • Hi,

    Thanks, I have been to the emergency room twice and they keep telling me to go back to my doctor and i keep telling them my appointment is to far away and my doctor says give it time i cannot get anyone to listen to me. I am calling my doctor this morning and telling him this cannot wait any longer.

    I just cannot believe this is actually happening to me at all. I was so happy at first when my legs had stopped hurting and other pain had just vanished then all hell broke lose its a nightmare.
  • Hi,

    If you are not in alot of pain do NOT take the risk at all it's not only a huge huge surgery but you could end up in a position like i am don't even consider it. I waited till something had to be done and its a disaster while it normally goes well it doesn't always and i am a good case for something went wrong please don't risk it for your own sake!

    And i doubt running would be something you could do again anyway maybe but i wouldn't count on that as a real possibility
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