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Scheduled for TLIF and Scared Need Information

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:36 AM in Back Surgery and Neck Surgery
I am 46 years old, have Cerebral Palsy, DDD (L4 and L5), totally collapsed L5 or L5 S1 disc (not sure which).I have had PT beyond reason, numerous nerve blocks, multiple nerve ablations, and cortisone injections. My L5 disc herniated in June after the last RFA (MRI confirmed). I have now watched as pain and numbness has taken over my right side. Numbness has now moved to my left foot. I have burning, throbbing, soreness in my spine and backside. When it’s really bad, my backside feels as if it is literally on fire. My right leg is weak, the thigh is sore and throbs, my knee can hurt, my right lower leg and foot are partially numb. The more I walk or stand, the more severe the symptoms get. Consequently, when not at work (desk job) I spend the great majority of my time in bed. My os told me the only option left is a TLIF including total removal of the facet joint which is so arthritic that it is 3 X normal size, cleaning out the inner disc material, putting in a disc replacement with bone graft/fusing with rods due to spine instability. I have good insurance but know this procedure must be very expensive and I am worried about out of pocket expenses. I can’t get any clear information about the cost of the procedure. Can anyone give me a realistic idea of what 3 days in the hospital and the surgery could cost (live in the South)? How long on average does it take before you can go back to work if successful? How much post op pain is there? I am no wimp when it comes to pain, as I have endured a hell of a lot already. I respect my os, he is well trained and highly respected in his field. I firmly believe he would not recommend the procedure if he didn’t really believe it would help me significantly.


  • It sounds like you are in sufficient pain now that surgery may be a relief! The first week is no picnic, but they will keep you well-medicated, in the hospital and afterward.

    You can read about TLIF here if you haven't done so already: http://www.spine-health.com/treatment/spinal-fusion/transforaminal-lumbar-interbody-fusion-tlif-back-surgery

    It is important to recognize that recovery from fusion is a long, slow process. It will extend far beyond the time required to heal the surgical site.

    Regarding returning to work, that is a very individual thing. Generally surgeons advise three to six months...anything sooner than three months is pushing it a bit, but there are some who have done it!

    There are many posts regarding fusion on this forum. You can run a search to find them and can read them, if interested.

    I cannot comment on expense. I had no out-of-pocket expenses -- everything was covered. Perhaps someone else can chime in with some information on costs.

    Best wishes for an uneventful procedure and a speedy recovery.

    xx Gwennie
  • which equals a TLIF. Both surgeries cost approx. 120K each. So having it all done at one time, I would think would be a little more, maybe 150K? The hospital that my NS used seemed to be expensive and he had another general surgeon do the stomach opening part. I have a $2500 maximum out of pocket and I don't remember what I had to pay since they were both last year.

    Recovery for the Anterior surgery for me was somewhat easier. I could see and take care of the incision better. It was in front and just seemed to not be as sore after the initial week or so as the back approach. I did have fluid buildup more in the stomach incision than the back incision. I had so many muscle spasms after the PLIF since they cut the muscles and my scar is long on both sides. I went back to work after 9 weeks with the stomach surgery and after 9 weeks again with the thru the back surgery. I felt a little rushed, but I had an office job programming and could ice/heat things and take my meds and work around taking care of myself better.

    Good luck with your surgery. I had no hardware at first than had hardware put in thru the back to stabilize everything and that made a world of difference to the pain level. Now, almost a year later, I still have some aches and sciatic nerve pain now and then, but it's nothing like it used to be. Before I felt like I had steak knives driven into my back.
  • You're right, I am ready to do whatever it takes to get my life back. Sounds as though it is indeed going to be quite painful. But if I can stand mapping and burning of 6 nerves while awake then go through it a second time for 6 more nerves on the left side, surely it can't be more excruciating than that! Let's hope! 3 to 6 month, eh? Yikes. :SS My os is doing the procedure endoscopically which will forgo cutting muscles pushing them aside instead. He will approach from the side and says incisions will be 3mm in length. I know he will be tearing apart and reassembling my spine but hopefully this approach will lessen damage and speed up healing. Sure hope I don't have to go out on disability - really don't want to. Wow, 100% insurance coverage.You are incredibly lucky. I will be paying 15% of whatever insurance says is allowable and I thought I had good coverage.
  • Sounds like you have been through the ringer. 2 very tough surgeries the hard way (not minimally invasive) and with several bad complications. So sorry about that. I hope that the fact that my procedure is being done endoscopically and all at once will reduce the overall expense. Being in the south, the prices tend to be somewhat lower and my insurance (at least up to now) has generally cut submitted charges to a third. But, this is massive back surgery so I really don't know what will be negotiated. I guess I'll just have to wait and see and work out a payment plan if the bill is as big as your figures suggest.
    I would like to know if you can feel the hardware once it is in and if that in itself causes pain. Hope things get better for you.
  • I'm 44 and live in Alabama. But neither of my NS offered the endoscopic surgery. That sounds so much better than a big incision. I'm about 40 lbs overweight and cannot feel the hardware. I can feel the tightness that the hardware has made. The big thing afterwards in PT was to keep the hamstrings stretched out. I guess the low back muscles all connect thru the bottom down the backs of the legs and they must tighten up after surgery. I was told by the surgical nurse that the biggee after these surgeries is scar tissue and arthritis that sets in. She said that within 5 years, it's a 50/50 chance to have the aches and stiffness increase. Some have to have the hardware taken out. She said it's like a body rejection thing where the body tries to coat and cover up the hardware like a foreign object that shouldn't be there. Weird, huh?

    Good luck and thanks for the well wishes. I'm 3 weeks out from my 4th surgery....2 back, 2 neck. So right now, my low back is lower on my list, but still there. :) Ask anything or PM me if I can answer anymore for you...I'm also a great listener.
  • Good luck on your next surgery. Hopefully, it will be smooth sailing this time around. As far as the hamstrings, my CP makes them a major issue(tightening) all the time anyway. I am small so hopefully my os will fit carefully match my frame. My surgeon is Edward Pratt who is highly respected and from what I understand, stays up on the latest techniques. I trust him and I am hopeful. If insurance doesn't delay things, I should have the surgery mid to late October. Will let you know how it goes.
  • You have certainly gone through a lot, and hope this upcoming surgery will help relieve you of your pain and give you back your life.
    I would ask your surgeon if another patient he did a similar surgery on would be willing to talk with so you could get an idea of what you might expect in the way of the recovery, hospital costs, etc.
    You also might want to check if United Cerebal Palsy could put you in touch with another person who has had the same/similar type of surgery to get their input on what to expect as well. In any case, you've come to a good place, lots of good info and nice folks too. Please let us know how things work out.
  • Thanks for your ideas. Actually, contacting UCP is a very good idea, should have thought of it myself. And, once my os office calls with insurance clearance and an actual date, I will indeed inquire about talking to other patients. Sometimes it takes another person to see the obvious! I will update everyone once I get further along in this "adventure", shall we say? Thanks Again.

  • and it's my pleasure. IMO, when you're in constant pain, fretting about an upcoming procedure, what you have to do beforehand and at wit's end, what would normally come to mind just dosen't. Take care!

  • and it's my pleasure. IMO, when you're in constant pain, fretting about an upcoming procedure, what you have to do beforehand and at wit's end, what would normally come to mind just dosen't. Take care!

  • sorry for double post, hit button twice I guess
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