Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

anterior fusions

AnonymousUserAAnonymousUser Posts: 49,670
edited 06/11/2012 - 8:30 AM in Back Surgery and Neck Surgery

I have just joined this forum having been told that I require a one level anterior fusion to the L5 - S1 (with metal).

Despite feeling that it may give me hope as the instability of my spine means I can't plan to do anything because I never know where the pain will hit next, reading this forum has given me grave concerns about undergoing surgery that is due in five weeks time.

I have been having physio and tried the injections, but both the surgeon and my osteopath believe that surgery is the only thing that can help. I feel very scared though having looked at not just this forum, but others and don't know if I am better off with the limited life I have and still having the ability to walk around (sometimes)albeit less than normal or risk some of the things I have read on the forums. Is there anybody who has had an improvement in their condition following the same kind of surgery to the L5 S1. I have to make this decision soon.




  • I had this surgery in January and have had a successful outcome thus far - spine surgery isn't the same for everyone but in my case I'm so glad I did it.
  • since I have surgery scheduled for late July. They will fuse L4/L5 and I get an ADR at L3/L4. I am concerned about the fusion but my surgeon insits that the post op studies for his patients show better results after the hybrid compared to a 2-level ADR.

    I have the same issues and concerns after reading some of the posts with people feeling more pain after the fusion and that leaves me wondering if I am doing the right thing. I will just have to put my faith in the surgeon since he knows way more than I do.

    Good Luck
  • Have you looked into artificial disc replacement (ADR). I just found out after having a failed anterior fusion and broken hardware that if they go through the front it doesn't give as much support as it would to do a 360 (both sides) but that is one docs opinion. I don't know how they determine whether they are going to do posterior (back) or anterior (front).

    If you are hesitant to have the surgery, maybe you should consider getting a second opinion from a surgeon not affiliated with your doc's practice.

    Everyone's outcome is different. Some people fuse and some don't. I don't know percentages. Are you having bone put in there either from yourself or cadaver?

    I understand how discouraging it can be to see all the negatives of the surgery on here. You have to keep in mind that most successful fusion patients are out living their actives lives and not sitting here looking for answers to pain they don't have anymore. It is nice to see others post successful stories and it's also encouraging so thanks for doing that, aimless.

    I don't blame my surgeon for my situation. I am just one of those that don't fuse and now have broken screws from not having the support I should've had if I had fused. I'm not trying to discourage you from the this surgery in anyway. I just want to be 100% up front and honest. I think a second opinion may ease your decision to have the fusion.

    Good luck and God bless. Please feel free to PM me if you have any questions or concerns. Also, please keep us updated on your progress before and after surgery.
  • Thankyou for your reply, it helps to balance some of the more negative.

    I am not on any regular painkiller, although I take Solpadol when it gets too much. Worse time is in the morning when I feel like someone has poured concrete on me overnight and it takes an hour to pluck up the courage just to turn to my side in the first step of getting up (usually three stages). Once I get moving it is OK on the whole, but still limited in how much I walk, how much I sit (this is the worse) and trying to plan anything because of the unpredictability of it all. When I have a good day I think do I need this op, but then I have a rough day and think I do. In Feb I had a discogram and was unable to do anything at all for two weeks. Couldn't walk at all, couldn't sit up at all and was in screaming pain on the maximum amount of painkillers. If they had offered the op there and then I would have taken it. however, I do physio twice a day, walk in water most days and take Glucosamine Sulphate once a day. This has led to an overall improvement from the post discogram days, but still unpredictable and a very limited life at the moment.

    Thanks again for your comments
  • Thankyou

    I have looked into disc replacement and been informed that I am not a candidate for this because of the erosion of facet joints etc

    I also have had a second opinion as the surgeon who undertook the facet joint injections etc in August 2008 was the first to identify the need for the fusion. My original surgeon then did a further MRI and discogram and came to the same conclusion.

    It is such a difficult decision because sometimes during some days I really don't feel I need it. Having said that I haven't worked for the past two months, been told to stay by the side of the pool when I walk through it (in case something happens and I have to hold onto something) and not to fly, travel far etc etc so it seems OK as long as I don't live my life I guess I will be OK.

    I really don't want to end up worse off than I already am.


  • You are thinking exactly what I am. My concern is I can't do what I normally would do right now but if I have comlications from a fusion what do I do? I have always been very active and plan to travel more and eventually retire on a golf course but not if I can't do anything. The catch 22 is that my condition is getting progressively worse so I have to do something.

    I guess it is fear of the unknown which is why we are in this forum to receive input from people who can inform us about similar issues and the successes and failures.
  • Hi Khumph

    I know how you feel. We had planned to spend our future travelling and that seems to be in jeopardy now from what I am reading.

    I have had back problems on and off for 25 years, but to be honest, despite around five prolapses over that time (no interventions,just continued as normal), I didn't feel it affected my life too much. The past year has been a different matter. Started with a severe prolapse requiring decompression, but just before due to go in for this the surgeon announced that the prolapse had corrected itself and it was the degeneration now causing the problem.

    Hopefully, we will both get to do what we want in the future.

    The instability is the nightmare for me I think.
  • my surgeon only used cages for the anterior fusion and I had too much movement in the vertebras that one of the cages has moved out into the spinal canal. I had the PLIF w/hardware to stablize me and now I'm feeling less pain. I still have achiness and sometimes a little burn feeling or tingle down my leg, but it's nothing like before the first ALIF or in between the ALIF and PLIF.

    The ALIF, I was healed up pretty well after just two weeks, but had a little fluid leakage. I could squat and use my grabber to do small tasks around the house. I couldn't lift anything more than 5 lbs until I was two months out. I got to drive after 3 weeks. So things aren't just to where you can't do anything at all after an anterior fusion. I felt pretty well. Upon going back to work at 8 weeks and trying to go back to "normal" life tasks that I started to get more pain. But my situation is rare.

    If you are getting the metal plate or screws for stablization, then that's a good thing. I still can't believe that my surgeon didn't use anything for my ALIF. But, live and learn.

    Good luck. I just wanted you to know that the actual ALIF surgery isn't as bad as it sounded to heal up from. It's definitely major abdominal surgery, but it was easier cause I could see it, take care of it, it was where I naturally bending at when you sit, so it didn't pull as much and all of that.
  • Thankyou Candle99

    The surgeon has said that they are doing the anterior one level only just to stabilise the situation. They are putting metal rods and screws in just at L5 S1 (if I can get the courage to have it done).

    Were you left with a large scar? I am imagining a 9 inch scar down my tummy.

  • I have said this before in here and I'll say it again. The time to do something is when you have to compromise your life because of it. I put off a corneal transplant for 16 years. I put off a knee replacement for 14 years. Both caused me to compromise my life. I missed things I can never get back. As for my back, I really had no choice to make. Or I guess I did. I could have spent the rest of my life in a wheelchair devouring pain medication. Or I could roll the dice and take a chance on a very risky, 5 level, 360 degree fusion. My life is better because I took the risk.

    Emergency surgery in March of 2006 for spinal infection of L 2 and L 3. During surgery, discovered I had Cauda Equina Syndrome. Spine became unstable after surgery and had 360 fusion with 10 pedicle screws, plates and rods in April of 2007.
  • Hi dbarbeau48

    Thankyou for your comments. My life is definately compromised and I didn't have any doubts about the surgery until I started reading forums. I have been informed that there is a 75% chance of success, 5% chance of something going horribly wrong and 20% chance of no change. I guess reading stuff meant I was focussing far too much on the 5% and not considering that I could possibly be in the 75% success rate.

  • Not sure if your surgeon would do the incision for L5/S1 the same as mine was for L4-5. I have about an 8 inch scar one inch to the left of my belly button vertical. A friend of mine had ALIF on L5/S1 and they did hers like a c-section incision would be ...horizontal and about 6 inches across down low just above the pubic bone area. Mine has healed up straight and if I hadn't gained about 10 lbs last year, it would look smoother LOL. I put hydrogen-peroxide on it while it was healing after showers and dried it with a blow dryer to keep it from getting gooey or anything while I had to put gauze on it. That helped a lot!!
  • this is my first post here but i have followed this forum since january.I also tried all other options and finally agreed to alif L5-S1 surgery. after first visiting this site looking for info pre-op,I too,was ready to call the whole thing off,very scary stuff here!! The fact was I was truely out of options, i was barely able to work and not able to enjoy my time at home with family. I had surgery feb 9 2009. alif with cage and four screws. The first two weeks were the worst but by week five i was just taking tylnol. By week six my original pain and some new ones appeared. i am at week nine now and beginning to improve again. have had to have pain meds the last three weeks again but not around the clock. set backs are normal and in my case they moved my spine back and up into position so my new pains are from nerves and muscles working from new positions now. I am hoping to return to work in a few weeks. Doc says ideally I will fuse and nerves will settle down soon.As you will read here, everyone and every surgey is different.My spine was slipping forward along with pars defects and facet joint problems, so my condition would only worsen with time.All i can do now is hope for the best and be able to get back to work and play soon.Thats my story so far. just remember to look at your life situation and your docs opinions and try to draw from the positive of these forums that fit your case and not be scared of the negative outcomes here. Hope this helps.
  • Thanks Stacey

    It sounds like we may have similar issues. I have been told that there is problems with my facet joints, certainly they are not good enough to enable me to have a disc replacement. The GP informed me that if I didn't get the op, the condition would worsen over time with more pain. not sure if I could take much more really.

    Thankyou again for your comments. It is scary when you read lots of negative experiences when faced with such serious surgery, but guess people must feel so strongly when things have gone wrong.
  • The first time I read this forum, I got up from my computer and told my wife,,,NO WAY AM I DOING THIS!! The reality for me was that without it I was heading for unemployment and a lifetime of drug therapy. At 40 with a wife and two young kids, it just was not an option for me. I belived you asked about scarring and such. My runs from below my belly button to just above my pubic bone.I have had no issues with the incision since about week 4.I had surgery on monday morning at 8 and was off of IVs and out the door tues at noon. a little soon for my liking but i believe they wanted me out to keep from chances of contracting any type of infections from the hospital.Both of my drs. are known for keeping thier patients infection rate the lowest in our area.Like i said before the first 2 weeks are hard but it does improve quickly after that. at least in my case.I do feel for the ones here who are suffering and i send my prayers to them.If there is anything else you have questions on,feel free to ask.
  • Hi Stacey

    Thanks very much for your comments. I am 45 and also concerned about my job. I have had a constant problem with the back since November 2007. Prior to that I had 25 years of back problem that would come and go (including five prolapsed discs in the same place over time). GP used to tell me to rest and it used to do the trick then I would be up and about again. However, the final prolapse in 2007 was it really. Although the prolapse mended itself, my disc is totally eroded and the facet joins have problems too. I continued to work up until the end of Jan 2009, when i just couldn't sit for 10 minutes without being in agony. I haven't taken painkillers on a daily basis, but struggled along as best I can. Physio hasn't worked, nor have the facet joint injections, which leaves the surgery the only option. It is so difficult because some days it is bearable with just sharp pains in my left buttock or throbbing back pain. Others, I can barely get out of the bed because of the pain from waist down, including pelvic and both legs. More recently, I am beginning to get pain in my upper back and arms and this is starting to worry me even more. I never know when or where the pain will be from one hour to thenext, which makes it difficult to live life really.

    Work will be OK to a certain degree, but I find that I am constantly compared to people someone knows and judged on this accordingly e.g. one person said their (professional athlete) son had a decompression and was back to playing his sport within four weeks and flying abroad. Therefore, I am now expected to be back in work four weeks after a fusion. It doesn't help really.

    I think that each individual has a different level of pain level as well. When I had the discogram the consultant was very surprised that I had continued to work with minimum medication for a whole year and said that I must have a high pain threshold given the state of the disc.

    Anyway, thankyou so much for your words of support. i guess I am probably going to have to bite the bullet if I am to have any kind of life again.

    I am glad that youhave had a more positive experience from the op and I do understand why you would have gone for it.
  • I waited over three years before I had surgery as I kept thinking there must be a better way! But there weren't any new developments and I could no longer stand for more than about a minute and I was driving down my driveway to get the mail. I had never had any surgery before and I was really expecting the worst from all the reading I had done. As a result it wasn't as bad as I was anticipating.

    The worst thing about a back problem is that absolutely EVERYONE knows someone who has a back problem, or they have experienced it, and they assume your experience is exactly the same. If I hear one more person talking about the agony of the pain they have once in awhile and then they take two aleve and lie down for an hour and are fine....very, very annoying. And you're right. They do not understand why it takes so long to heal. In every other surgery, you recover from the surgical procedure and are fine to go about your business. What could be so different about the back????

    When the time comes, you will make the decision that is best for you.
  • Perhaps you should ask your colleagues to visit this sight! It may give them some insight about the surgery and the differing results. People really don't understand!
  • Hi Nancy

    I think some people are so pigheaded that even visiting the site wouldn't help. The person with the athletic son (half my age) told me that I was seeing the cup only half full when I mentioned that I couldn't be in work because I couldn't walk properly. I think he thought it was mind over matter. I felt like posting the MRI, discogram and surgeons letter to him, but at the end of the day what does his opinion matter.
  • Thanks Gwennie17

    you are right about the back issue and how if they lift a box it is a bit sore and then that is compared to some people who can't walk, sometimes don't have control over bladder etc. It is about perception of disability and unless I am seen walking with a stick or a frame or in a wheelchair then I can't possibly be disabled. it is frustrating and hurts when you are already in constant chronic pain and facing such serious surgery.
    Before I was forced to go sick from work (by my GP), one of my colleagues walked into a room as I was holding onto the wall to walk to a printer (and my leg was giving way under me) and said that I was putting it on for him, or, I obviously wasn't on strong enough painkillers. It was at that point I decided enough was enough.

    At least we have this forum of people who understand and can share experiences.
  • I am similar to you in that my back problems really become a problem in 2007. Before that I would hurt about once a year for a week or two and be ok for the rest of the year. Just minor aches and pains here and there. I ended up getting ALIF L5/S1 with cage, plate and 4 screws 7/1/08 after all other conservative methods didn't work.

    The healing process wasn't too bad. The first 2 weeks were the worst and I was pretty much stuck in bed except for 1 wk after my surgery I had to go to my Aunt's funeral. She died the same day as my surgery. The incision healed great and I didn't have any leakage. I did have 2 stitches that came up through the skin that scared me. I didn't know what it was cuz I never had stitches or surgery before. My incision was more painful that my back and my stomach wasn't too bad. My stomach would hurt to sit up or get up and walk around for the first couple of weeks.

    I was driving after 2 weeks. I also had a lifting restriction due to incision for 6 wks. I couldn't do any exercises until after 6wk restriction was lifted. My scar is not too bad and is about 6 inches horizontal near bikini line. I wore the support brace they gave me in the hospital for my incision for quite some time cuz if I stood too long it would feel like my stomach was going to split open at incision site. Very weird feeling.

    I was healing very well for the first couple of months and was slowly weaning myself off narcotic pain meds. Then I fell down my steps and landed on my knee and my back started bothering me again and it was getting worse and worse by the weeks. I had to go back to taking more pain meds and was going downhill. Unfortunately I am in the 5% that was mentioned above. My body did not grow the bone to fill the space where part of my disc was removed therefore, there was no fusion.

    I know how scary it can be reading all this before having the same surgery. I don't know if I would've gone through with the surgery if I had found this site before surgery or not. It's hard to say but I'm sure I would still pick the surgery cuz the probability that my quality of life was going to be better, I would do it again in a heartbeat.
  • I have to agree with the other posters - it was quality of life that drove me to make the surgery decision (after 11 months of conservative treatment).

    Ming - you asked about how surgeons determine whether they are going to do posterior (back) or anterior (front). I think its a great question to ask your surgeon; I know in my case, I had too much risk for further degeneration if we did posterior. I also don't have a weight issue so anterior was not a problem (I understand one's tummy can't be too big for this to be a feasible approach).

    My scar is about 4" down from my belly button, about 4" long (horizontal). I put vitamin E oil on it every day in hopes it will fade a bit.

    Nervous before surgery? Heck yes, my heart rate was 148!! They almost didn't proceed! But I calmed down, and the worst part of the surgery for me was the anesthesia nausea for about 24 hours post op.

    Julieann - only you can make the decision. Ask your surgeon lots of questions, no matter how insignificant you think they may be (what kind of hardware? Post-op range of motion restrictions? Post-op medications for pain control? Will he use BMP, cadaver bone, your bone, a mix? Can you speak directly with a patient who has had the same procedure in a similar situation with their spine?) My surgeon teases me, I show up with these typed out lists of questions, but I felt so well prepared. PM me if you like.
    Good luck.
  • Unfortunately for me I have never been given more than five minutes with my surgeon to explore all the things I need to in order to make an informed decision. he has pretty much quickly run through the risks and what they will do. I did ask whether I should put my salsa shoes on Ebay and he said he didn't think it would be necessary as I would be able to use them again in the future (if successful).

  • I truly don't know what to do. The instability means that I have OK hours during the days and not so OK hours during the days.

    I have noticed that many people are on a myriad of tablets to help with pain etc. I manage to go most days without any medication and from this I wonder if I am bad enough to warrant putting myself through the extra pain and risks of everything with the surgery. Although I rarly venture too far from home and currently don't work, which means I have the restricted life.

    Does anyone know of anybody who was offered the fusion and refused, but later regretted it?
  • there are people on this site that "chickened out" before the surgery and live on pain killers for some time only to go back for a future surgery. I myself cn't live on meds and am scheduled for my procedure late July. I am getting in the best shape possible to make the healing process easier (which I highly recommend since post op I will be a tub of goo).

    I read some of the horror stories on this site but believe that if I do my part and provide my surgeon a good "canvas" to work on I will be fine. Some doctors did not want to perform any surgery explaining that I did not have pain down my legs so why bother. They don't live with my lower back pain and the constraints it has on my life.

    I used to be able to do anything and now hobble around and become a fricken invalid after minor yard work. i have 5.5 acres of hillside land and now I am forced to hire help to take care of it all. This all sucks and I am trying to do something about it! Sorry for sounding angry but it is my frustrtion and know you understand it.

  • Thanks Ken

    I am in the same boat really and like you, have been really working on myself in preparation. I completely changed my diet, I do physio (back strengthening)exercises three times a day and also walk in water 3-4 times per week as advised. Unfortunately, I still have the odd cigarette that I am desperately trying to stop, unfortunately, reading these stories has me reaching for them.

    It is just that some days I have such a good day, albeit I am doing nothing away from home and I wonder whether that is better than what I have read about some of the situations on here.

    I have coped for 25 years before the latest prolapse in 2007, but it has never mended since then which is why they are suggesting the fusion. I am starting to get upper back and neck pain now as well, not sure what that is about.

    Thankyou again, it is nice to be in contact with someone in the same kind of situation
  • Mine was at L4/L5 with the ADR done from the front and the hardwear from the back. It has been almost 5 months and I feel so greatful for the surgery and surgeon. I am back to my old self. I am looking forward to gardening and traveling pain free for the first summer in a many years. The decision is yours alone but I am so happy I did it. Best Wishes
  • Thankyou Pika, having someone say something positive about the op makes a big difference and helps to balance the stories from those with less fortunate experience.

    Really glad you are feeling good and looking forward to a nice holiday. I am hoping to go on a cruise at some point in the future when (not if) I get better.

  • ... that 90% of the people that come to these forums are having/had problems, so it will seem like there are more problems than success cases if you read these forums.
    If your head feels fine after you take advil, you don't join a headache forum :)
  • Hi Rolo

    I agree. The difficulty is when faced with this kind of op I have looked for research/others experience and unfortunately, I don't know many people who have had the surgery I am having so dependent upon what is out there. I definately think that if I go ahead (after all I have read) and it is successful I will post on the site just to let others know who are in the same place as I am at the moment.

Sign In or Register to comment.