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L5 - S1 Fusion

AnonymousUserAAnonymousUser Posts: 49,670
edited 06/11/2012 - 8:35 AM in Back Surgery and Neck Surgery
I have been dealing with a fractured L5 for the past several years. Intense shooting pains down my leg(s) and alot of numbness in my right leg. It has gotten tot he point where I cannot really stand for much longer than an hour without pain and forget walking anytype of distance. I have tried everything from injections, to stretching, to PT to meds.. My wife and I met with the Dr a few days ago and we dicided on fusion in October. Here are my questions.. Can anyone help me?

What is the recovery timeline like?
Will I be up and walking after surgery or am I stuck in bed for weeks?
Pain involved?
Will I be able to do any type of exercise during recovery?
How did the surgery effect anyone here?

Any detailed info on this surgery would be greatly appreciated!!



  • Man this site has sorta bummed me out.. It is like the "Horror Story" website.. I went back and looked at older threads in most surgery cases and have not really found many if at any "positive" stories about individuals and their back surgeries.. This really has me worried now..
  • Welcome to Spine-Health.

    Please don't use the posts here as a guide to whether fusion surgery is generally successful or not. You find a lot of bad outcomes here because the ones who have had a successful surgery move on with their lives and no longer post here because they don't need support any longer.

    There are some who've had success that still post to help people like you, who are facing surgery, but many success story patients are no longer here. But, believe me, there are a LOT of successes out there.

    The only thing I can comment with regards to your questions is that walking is the one thing that all spineys are encouraged to do, especially after surgery. You'll be encouraged to walk a much as you can tolerate and gradually increase the amount of walking as your recovery progresses.

    So, please don't use this site as a guide to success, just use it to get as much info as you can regarding your surgery and ask for help from other members when you need to. You're not alone in your back pain and we're all here for you.

    Take care,
  • Everyone has a different experience and result.Hard questions to answer.Everyone's pain tolerance is also different.Have had many surgeries-3spinal-rotator cuff in shoulder-pin in knee-ankle scope.My lumbar fusion was the most challenging-and continues to be.It takes MOST a year to develop a fusion.If all goes well,MOST will get out of bed{with assistance and reluctance}the second post op day.You can do exercises in bed- but until you have developed a fusion MOST-will not be able to lift-twist or bend.It is common to wear a brace until bones fuse.Walking is encouraged-around the house at first with a gradual increase according to your pain tolerance-lying in bed is not. The surgery affects everyone differently-L5-S1 is an area that doesn't move much so IN A PERFECT WORLD mobility is not affected much.My surgery relieved the pain in my foot and leg.I have back pain now that I did not have pre-op.It takes commitment and daily work to maintain my back.It changed my life in many ways.No more high impact sports or exercise.I don't want to have to go through it again. MOST will start into physical therapy within 3 months.Any fusion puts more strain on discs above and below it-so being kind to your back is important.I HAVE TO THINK ABOUT ANY ACTIVITY BEFORE I DO IT AND USE PROPER BODY MECHANICS.I was extremely active before surgery and am just now learning to accept my limitations.Can't comment on the pain.That is according to your tolerance.Read recommended literature written by physicians so as to be as informed as possible.You will then have some idea what kind of "discomfort"to expect.It was important for me not to listen to other people's back stories{-some good-some bad}and to just have my own experience.Hope this helps.This site has helped me a lot.
  • I am 9 months out from a PLIF L-4 to S-1. My surgery was 8 hours long. I woke up to enormous pain, but it was controlled by pain meds fairly well. I did not get up till second day, and that was for 2-3 steps. The third day it got better, slowly each day. The recovery from this surgery is long and boring! It is something to take very seriously as it affects everything in your life. No lifting bend or twist. I had pain for the whole time and last Friday was finally fused enough to take out hardware. The Ortho thinks that this is what was causing major pain still. Time will tell, surgery was 2 hours and I can do much for another 2 weeks. I had 3 torn discs that caused great pain before surgery, so it was a matter of anything was better than the way I had been for 2 1/2 years.

    It is a long process, but if you are having problems, I would do it again, just because I wanted my life back. Another thing to think about is, by waiting are you going to cause any more damage? The surgery is huge, but I think the younger you are the better and faster you heal. No one can tell you what to do, as it is only you that knows your pain level and how you will handle not working for more like six months to a year. Good Luck with your decision and if you do have it done, keep us posted. Make sure your surgeon is top notch and does this regulary with good results. If I can anser any questions, please feel free to ask them.
  • I can only offer my experience, but go with your gut. Be informed of course, but go with your gut.

    What is the recovery timeline like?
    I had a two level L4,L5,S1 in Novemeber of 2008. I am still recovering. I was in the hospital 5 days. Home for three months. Back to work part time for two weeks, full time for two weeks, and then back to part time again. I decided to quit shortly thereafter. At first I could only walk a bit, and then a bit more, and then more than I ever was able to before surgery.

    Will I be up and walking after surgery or am I stuck in bed for weeks? Walk or lay down, that was about it for me. I walked several short trips a day until I could take longer ones.

    Pain involved?
    For me the pain upon waking was excrutiating. Docs had a hard time controlling it. After they did though it got better and better. Still, the sneeze that I had before surgery put me in worse shape than my post surgery pain.

    Will I be able to do any type of exercise during recovery? I dunno, the doc and physical therapist will have to counsel you on that. I walked and stretched and did some minor strength exercises.

    How did the surgery effect anyone here?
    I don't regret the surgery but things are not perfect. I cannot bend without pain and I shouldn't be bending again according to the doc. I have some nerve damage caused by the root retraction during surgery that most likely will never go away. I am different than I was, and will never be the same.

    I am also very blessed and grateful for the improvements that were made too.

    That's my piece and peace. :)

    One Love,

  • Alot of people who have had a successful fusion surgery (myself included) do not spend much time on the message boards, as the support is no longer needed. I check in every so often and feel compelled to tell you there are LOTS of success stories out there! (Just don't look for many of them here :))) )

    What is the recovery timeline like?
    Walking the next morning, left the hospital 3 days post op. Walking a couple of blocks within a week or surgery. Walking 3 miles a day 7 weeks post op, back to work 8 weeks post op (desk job).

    Will I be up and walking after surgery or am I stuck in bed for weeks?
    Doctors want you up and moving ASAP.

    Pain involved?
    I had a pain pump but kept forgetting it was there so I guess the pain wasn't bad. I was nauseous for 2 days from the anesthesia though. Once I was home, I took percocet but quickly weaned off of it.

    Will I be able to do any type of exercise during recovery?
    Walk walk walk! It promotes bone growth. You won't be able to stretch, and I ACHED but it was worth it!

    How did the surgery effect anyone here?
    Changed my life. I would do it again in a heartbeat.

    Best of luck to you.

  • What is the recovery timeline like?

    Recovery is different for everyone, I've found being as positive as you can makes a big difference in how it goes. I was DX'd w/ DDD, stenosis, herniated disks, spondylothesis in early May L4-5, L5-S1 and the OSS I saw felt I was a good candidate for minimally invasive TLIF surgery. I was told it might be an ambulatory procedure, but, more likely I would need 1-2 days in the hospital. Had surgery 7/6, released on 7/8 to my home. I'm about 75% back to my normal self at this point.

    Will I be up and walking after surgery or am I stuck in bed for weeks?

    I was out of bed & on a walker less than 12 hours after surgery, in fact, I was told the more I walked, the better it would be for my recovery, bone growth, etc. Progressed to a cane the morning following surgery and was able to ditch my cane 2 weeks post surgery. I am religious about my walks, got myself a pedometer since I find it easier to count steps and try to walk more steps each day.

    Pain involved?

    Again, IMO, it's individual to each person. I had terrible back spasms that started in recovery and continued until I was released to home. Went home w/ flexaril, valium, fentanyl patch, ultram mostly because of the issues I had w/ spasming. This 'cocktail' did the trick for me, I DC'd RX meds 2 weeks out, and used extra strength tylenol when needed. I did a lot of stretching early on (flat on my back) that the PT team @ the hospital showed me how to do, I continue to do this each day as it makes a big difference. Tight muscles for me equals the start of pain. Also, listen to what your body tells you, if what you're trying to do is too much, take a rest.

    Will I be able to do any type of exercise during recovery?

    There will be changes in what you can do since the mechanics of your spine have changed. I was given a very good report at my 5 week check and given the OK by my OSS to start going to the gym again, I'm using the treadmill & elliptical, lifting no more than 20 lbs at this time, basically I was told to go slow. I'm still not allowed to walk my dogs (they are large breeds), but this will come w/ time.

    How did the surgery effect anyone here?

    So far, surgery has made a tremendous difference for me. I had terrible sciatica, along w/ numbness & weakness down my right leg, developed foot drop, most of my foot felt like a block of wood, I did a great Quasimodo impression dragging my leg around. The leg pain was pretty much resolved after surgery, foot drop almost totally gone, I still have some numbness/tingling in my toes, but, I find it's getting better and I'm hopeful that I'll get most/all of the feeling back in my foot. Since I still have some weakness in my foot, I'm not back to driving as yet since I wouldn't be able to live with myself if I caused an accident.

    Any detailed info on this surgery would be greatly appreciated!!

    You don't mention what type of surgery you've been asked to consider. I think part of why I'm doing pretty well this early on is that I had minimally invasive procedures. I have two 1" parellel scars on either side of my spine. My TLIF consisted of fusions, foramenectomies, laminectomies, disk clean up, screws, disc spacer (Medtronics sextant instrumentation, DIAM spacer)

    Hope this helps
  • Im 19 and have recently had a two level fusion on L4-L5, L5-S1. The operation itself took around 3 or 4 hours. When i woke up there was a fair bit of pain but somehow my back felt more stable, and there were painkillers on hand to help with the pain.
    My operation was on the 19/08/2009 so we are only three and a half weeks on and i am out of bed walking on a daily basis and have been since the day of the operation as this is advised by the physios in most cases or so i am told so you need not worry about too much bed rest. With the recovery timeline i have been told it will be a slow recovery and that the best thing you can do is take it slowly do as advised and generally take it easy.
    With regards to the pain involved, for me personally i was in hospital for 5 days before being discharged with some piankillers which seemed to do no help by this stage so i stopped taking them and the pain is usually manage-able. It is a lot less than before i had the op. As for the exercise during the recovery this will be a case of how the surgery goes and lsitneing to your doctor and physio and doing what they say and no more.
    I hope this helps answer any of your questions, but dont take my advice from a medical perspective as i have no medical training and this is just from personal experience and i am a long way from full recovery have been told will take upto christmas to tell if the operation has been a success.

  • Well to be honest I am not sure of the EXACT name of of the surgery, I just know it is a L5-S1 Fusion.. The process is they make small incisions through the back, take out the fractured part that is now "floating" and not attached to my L5 out and clean area around where it was fractured, then they take some bone tissue from my hip bone and use all that for the fusion part.. They put the pins in to hold it in place therefore fusing the the L5 and S1 together.. Then they can go in at a later date and remove the hardware. Hope this helps.. Said the surgery will last about 4 hours and will be in the hospital for 2 days..

    Do they insert a catheter or can I just get up and go on my own??

    Will it get to the point where I can jog and workout again sometime in life??

    I am not looking to get an 18 year old back again, I just want to stop this pain and move on with my life..
  • It is a PLIF meaning posterior Lumbar Interbody Fusion. And they do put a catheter in while in surgery for the first day or so after surgery, as you wont be able to immediately get up. Jogging and working out are a way off in the future. Only your Dr can tell you that. Hope this helps.
  • I had my minimally invasive L5-S1 PLIF July 20 09'. And I haven't had any of the ill effects that I've read about. I'm not saying it is the fix all cure but in my case it seems to be alot better. My fusion was outpatient and they had me up walking within a half an hour of waking up. And then up walking every 20 min from then on. Tough at first but now 7 weeks post op and I'm only sore when i sit too long or lay in a bad position. And even thats getting better everyday.I'm doing alot of hiking and going back to work next week. Like I said thats my story and it's not the same for everyone.I don't recall talking to anyone else who's had an outpatient fusion so i know that is a little uncommon, but i've had freinds who have had fusions and not been out of bed for 6 weeks so I feel pretty Lucky to have had the doc I did. I hope you all find some relief!

  • I tell you the catheter idea scares me more than the surgery.. I am afraid as all get out to think about that!!! I am going to continiue doing reasearch before making my decision for my October 20th surgery.. After reading posts here I am really having second thoughts..
  • I tell you the catheter idea scares me more than the surgery.. I am afraid as all get out to think about that!!! I am going to continiue doing reasearch before making my decision for my October 20th surgery.. After reading posts here I am really having second thoughts..
  • I tell you the catheter idea scares me more than the surgery.. I am afraid as all get out to think about that!!! I am going to continiue doing reasearch before making my decision for my October 20th surgery.. After reading posts here I am really having second thoughts..
  • Jaws with your procedure did oyu have screws and pins put in?? How di dhtey go about doing the in and out procedure??
  • Good luck in your decision I know it is a tough one to make. I too struggled for a long time. There are definitely horror stories out there, but mine is not one of those.

    I am about nine months post op now and am glad I had the surgery although the recovery for me is a little longer and rougher than I had anticipated.

    The one thing that I was really worried about presurgery was the catheter, and for me it was a cakewalk. I was asleep when they put it in and it did not hurt when they took it out at all.

    The first three weeks of recovery were pretty rough for me and I moaned well with the rest of us. Even the first 3 months weren't all that easy.

    But gradually I got to a point where I was "better" than I was before surgery. And that was reason why I had my surgery, to get better. I knew I couldn't get better doing nothing.

    I won't tell you I feel 100% great, there is still pain sometimes, still some soreness, I still have restrictions on how much I can lift and bend. There were some new pains early on in my recovery. But overall I am better than I was pre surgery.

    For me I am able walk almost pain free, I could care less about running anymore. But I have climbed a few small mountains hiking about lately. I walk my dogs where they don't need leashes.

    I've been able to garden, hike and play with my kids this summer, all things I have not been able to do for a very long time. For that I am grateful.

    Good luck!
  • Well that is where I am somewhat confused.. You see I can still jog, I can still coach baseball, I can still climb, I just do it to a point where I have to deal with quite a bit of sharp pain in my hamstring and numbness down most of my leg.. I actaully feel like this most of the day and it has gotten to the point where it just "physically" has worn me down in life.. That is why I want to get this fixed.. I have those that tell me, "Hey, if you can still do those thengs then hold off on the surgery." However, I CAN do those things but in PAIN and I am tired 75% of the day from just dealing with it..

    But man that catheter still scares the heck out of me!!
  • In the great scheme of lumbar fusion, the catheter should be the least of your worries!! @)

    As you know, even if the surgery goes perfectly, there is no guarantee that you will come out of it with no pain. You might...but, then again, no one can tell you that.

    It is one of the more frustrating aspects of trying to make a decision. I waited over three years before decided to go ahead. I just didn't feel my story was as bad as others I had read about on various forums. In hindsight, I probably should have had surgery much sooner. On the other hand, it may have made no difference!!

    Unfortunately, only you can make the call.
  • If the catheter is the only thing holding you back, it should be a non issue. It is the most painless part of the whole deal. Only you can decide when you have had enough pain and want to try and get some releif. No one here can tell you, and there are alot of sucesses, just alot of those people have their lives back and are out doing the stuff we want to do. No surgery is guarenteed to be sucessful. You have to be the one that knows you have the right Dr with the right plan. If you are confident in that, then you just have to decide if you are ready or not. It is like you said, a huge decision, and I am glad I have mine behind me. Good Luck.
  • The only thing I can say with all the other posts here is to Listen to your body, they will have you up and about soon if not the day of your surgery. They will also give you an excerise work sheet to let you know what you should be doing at certain stages BUT as I said....Listen to your body, walking is the best and they will have you in PT and a positive attitude helps along way. Its a gradual process but do not over do it because you will only regret it if you try to play Super hero in this process.

    *Remember...Take it one day at a time*

    Good Luck and we are all here to help with support or if you just need to vent.
  • I'm still not quite sure how the got the rods and screws in there. But they did. I know they put tubes in, each one larger than the last to stretch the muscle and tissue so they don't have to cut it and then they work through the largest tubes. But I only have two small incisions (about an inch and a half) to either side of my spine.

    And the funny thing was I was afraid of the catheter too. Nobody mentioned anything to me, so when I woke up in recovery with one ( i didn't know i had it untill they got me up to walk). I just about freaked out. But it was for nothing it realy turned out to be no big deal.

    And I agree with dlady attitude is everything. Don't get discouraged, only you know what your body is doing. I could do all the same things you could and I plan on continuing my active lifestyle. Let me know if you have any questions.

  • I am 33 and had (not for sure the medical term.)microdisc. of L5S1 with fusion and hardware.....I had a herniated disc for over 10 yrs. due to injury and suffered off and on with pain, back and leg. It finally got to point I could do nothing w/o pain - no longer cleaned my house, didnt exercise, nothing physical due to pain. I had surgery 9/18 and aside from the major pain I had when I came to, I have had very very little pain since....I was up walking within 2 hrs of leaving recovery - I got up 5 times that evening to use the bathroom. I can honestly say I would have the surgery again if needed, because I feel great. Now, honestly, I cant get up and do anything right now and my lower back is still pretty swollen, but I only took pain pills for 5 days after surgery and thats it. I have needed them no more!! Every now and then I have a little twinge of pain, but thats it. I cant believe things have been this good for me. I only hope it goes as well for you.

    One thing I dont understand is other comments about taking the hardware out after fusion takes place? My dr. said mine would stay in. I will have to ask him about that next appt. I will say I can only get up and walk around the house....still not allowed to leave the house yet, which is the hard part!! Starting to get very depressed!! Such beautiful weather outside and I am stuck inside!! BUt I keep telling myself it will be worth it in the end!! To be pain free!! Which I am now!!!
  • Most people do not have the hardware removed after they have fused. But sometimes there will be a reaction to the product, or a screw will break or move, or something similar will happen, and the surgeon will decide that the hardware itself is causing pain for the patient. In rare cases, the surgeon will go back in and remove the hardware. It happens in something like 3% of all fusions.

    I'm glad you are doing so well after your surgery. Just remember to take it easy and not push yourself too much. Even if you feel great, it still takes awhile for the bone to knit together!
  • I dont plan on doing too much for the next couple of mos. although I have probably gained more weight than I would like, I know I wont be able to exercise or do anything for awhile,probably by spring, I can start to do mild exercises, like walking, small weights, etc.

    One thing I have had trouble with is the area/incision of the port or whatever its called, the thing that drained the fluid from myback while I was in hospital...that area is sensitive!! It stings some and hurts to touch! Anyone else have any trouble with that?
  • I know people have different stories of lumbar fusion. I did have L4-5 & L5-S1 removed then fused IN 2002. I had no choice. I couldnt feel my legs and a wheelchair was my future without it. All stories I heard really didnt help ease my stress of wanting to have this surgery at the age of 31. I was so scared that after 10 hours under the knife I awoke and started screaming I couldnt feel anything. What I was meaning to say was that I couldnt feel the pain any longer and I could feel my legs. I spent 7 days in the hospital because the first few days was dealing with drug withdrawal then I had to wait on a custom back brace to wear home and when I was out and about. I had to get out of the bed only with assistance until my body brace arrived.
    I went back to work in THREE weeks fulltime. I never again had severe problems. I occasionally have low back spasms but that is when I over do it and act like I am a kid again. I did give up some of my active lifestyle due to just plain fear of hurting my fusion. I dont ski any longer but the rest of my sport activities I didnt change.
    I didnt take any pain meds for low back pain ever again. THIS WAS THE BEST DECISION ON MY LIFE AND WOULD DO IT AGAIN.

    Just educate yourself to extreme and write down any question and ask your doctors. Make sure you find out what all your options are and then decide. It did work for me.

  • Hi there
    We sound like we have very similar issues.
    I had my L5 S1 fusion 2.5 years ago now, and I just keep going from strength to strength.

    Here is an overview of my surgery so you can hopefully get a few answers to your questions.
    Monday - admitted to hospital
    Tuesday - 7 hour surgery
    Wednesday - Out of bed with physio on zimmer frame
    Thursday - Out of bed on crutches
    Friday - Walked up and down steps, had a shower, went home!
    Monday - ditched the crutches, walking independantly!
    I was lucky the surgery went very well for me. I had two rods and four screws inserted and a metal cage in the disc space with bone grafts inside.

    Recovery took a total of 6 months before I was back at work, but you need the time to build your strength back.
    I woke up after the surgery and could immediatly feel the difference, I had pain from surgery but the pain I had before down my legs and the tingling had gone.
    It was scary getting up and walking but the physio's were great, not my most dignified moment however having two male physio's helping me out of bed one in front and one behind, with my surgery gown all flapping!
    Their response 'don't worry miss we've seen it all before!'
    My response 'Not mine you haven't!'

    Anyway I digress yes the pain stayed around but it is different pain, it eases the more you start to do and the stronger you get.
    My rehab programme included Pilates classes and it made a massive difference.
    And from 1 week after going home I went out every morning and walked for 45 min to 1 hour.

    This surgery gave me my life back! I had been unable to work, couldn't do the housework, or my own shopping I could barly walk. I was becoming more and more dependant.
    Now I have a better job, which includes a two hour commute on bus/train at each end of the day and I manage fine with it.
    I'm not saying I never have pain or aches but in comparisson to what it was like I hardly notice it.
    It is rare that I take painkillers now, but before I was on the lot!!

    My story is nothing but positive and I think you need to listen to the advice of your doctors and your own gut. I knew that I had to have the surgery if I was going to reclaim my life back, and I did!

    All the best of luck.
    Keep us informed of your progress.
    If you want any more details or handy tips don't hesitate to personal message me.

    Bye! ;-)

  • The links below have many positive outcome cases, and there are lots more. Trouble is, as Cath111 pointed out the successful cases move on with their lives and usually leave this site, whereas people with issues logically gravitate to this site.



    I am a highly successful L5-S1 fusion surgery candidate although I did have a hiccup along the way, necessitating my hardware being removed, but apart from that everything went well for me and I live a back-pain free life now. Click on the links in my signature to read more about my story.

    Keep positive!


    ...an old timer here and ex-moderator

  • Hi,
    I have had my spine fused in the UK and I only wish I had the operation sooner, I am 33 and have three children and have had problems with my back since I was 15.
    I left hospital better than when I went in, on less medication and with a great big smile across my face, I read all sorts on this site before I had my surgery, some put me off and others gave me hope.
    I am now so much better for having it, I smile and mean it. It has been hard and there are days when I still have pain and ache a lot, but it's nothing compared to what I use to suffer with, I came around after the op and the pain in my left leg was gone, I felt my back was more stable than what it had been for 22 years.
    All I do for exercise is walking, I am seeing my surgeon again next month for my xray and then hopefully start some rehabilitation plan.
    Best of luck to you, find out all you can and then make your choice, speak to people it helped me.
    Take care,
  • Hi all, I had a DIAM implant back in 2007, it worked for about 6 months and now I have been suffering with extreme pain for the last 1 year and 1/2. Now I have to have another surgery for disc removal..and fusion..it's been so painful...Has anyone heard of the DIAM implant? I can relate and feel for your pain, I can tell you.....
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