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What was your PLIF/TLIF L4/5 surgery experience?

Cath111CCath111 Posts: 3,702
edited 06/11/2012 - 8:38 AM in Back Surgery and Neck Surgery
Hi. I made another post about my poor mental health regarding my possible upcoming surgery, but can any fellow spineys share your PLIF/TLIF L4/5 surgery story with me?

I'd like to know what the surgery and hospital stay was like for you, and what your recovery was like also.

Please share your experiences with me so I have even an inkling of what I can expect if I decide to have this surgery.

Thanks in advance,


  • It took me three years to make up my mind to have it. I kept hoping some new technique would come along to rescue me from fusion...but it finally got to the point where I was becoming a shut-in, and my various docs kept telling me there were no new developments on the horizon.

    I had an open PLIF at L4-5 with laminectomy at L3-4 and general cleaning out of stenosis from the central canal and foramina. I also had spondylolisthesis, so things were pulled back into alignment. I had surgery on a Monday night and came home Thursday afternoon. I was pretty out of it at the hospital. I mostly dozed and napped when I wasn't up walking for PT, attempting to eat, etc. I didn't need to take a thing to the hospital, as it turned out, except for the clothes I came in with. After surgery I couldn't have cared less how I looked. All I cared about was pain, and not feeling it!

    I had a catheter and a drain. I had to wear their little hospital attire right up until I was ready to be discharged.

    Once I got home, I took my meds as prescribed and I took them for 8 weeks. Then I realized I was forgetting to take them so figured I didn't need them anymore. My son came and babysat me during the day when my husband was at work. I needed someone for the first week, but could have gotten along just fine after that. I had no trouble taking care of myself. I could dress, shower, etc. from the beginning. I followed the rules...I didn't drive for eight weeks because I was on pain meds, and I didn't really feel like going anywhere any way!

    I started PT at about 14 weeks. My surgeon was one of those who was ambivalent about PT, so he left it up to me. I didn't feel I was ready prior to that.

    Just prior to starting PT, I flew half way across the country with my son, and we looked at houses for five days, so I obviously felt well enough to do that. And I was able to withstand the receiving line and to dance two dances at his wedding five months after surgery.

    I'm not sure what types of questions you have. Let me know what I can add ....

  • I wrote a little about my experience at your last thread. Well, mine was an open 2 level TLIF at L4-S1 and they took out the L4-5 disc and put in a cage with something?...help me Gwennie, I forgot what's that's called again. :/ I also had titanium rods and screws. Oh, there's one thing they don't tell you about titanium- when the weather turns cold, it does too and it causes more pain. Invest in a good heating pad and use it over your back as directed. I was having the fusion because of a post op reherniation from a microdiscectomy and I also had retrolisthesis in L4-5.

    I spent 4 days in ICU and it was a blur to me due to all the meds. Find out if they will have you on a PCA machine- it was a lifesaver for me because the pain was incredible. It dispensed morphine and I pushed the button like a Play Station controller. Don't worry, it locks out doses so you can't get too much. I also had a Foley cathether which actually was a joy to me because it was out of the question for me to go to the bathroom. There was also a drain tube coming out of my 6 inch incision which made it difficult to get comfortable. I think it was the 2nd day that I developed a spinal headache, and I hope you never had one of those. They did a blood patch where blood is drawn out of your arm or IV and injected into your thecal sac to plug up the spinal fluid leak.

    Recovery was difficult and I had a lot of pain flares. They had no choice but to give me Toradol which is contraindicated if you are in the process of fusing. I finally made it to PT and they let me go after only a month because it didn't help. The therapist always complained that my hamstrings were super tight and the exercises produced nothing but electric jolts and painful muscle spasms. A couple months after PT it was confirmed that I had permanent nerve damage. My leg would give out unexpectedly and once I crash landed in a parking lot and I can't tell you how bad it sucked. That's why I always use my trusty cane.

    Well Cath I wish I had a happier story for you. I know things will be fine. Remember, no two cases are alike even if we have the same surgery. I hope your surgery will be successful and that you also recover completely. Take care
  • Hospital stay was only 3 days, and kind of sucked. But mostly because of 2 things- #1 lack of support because of relationship issues, and #2 crummy care by hospital staff during several points in my stay. But pain wasn't all that bad. Getting out of bed was rough, but once I was up, I could walk pretty far without any issues or pain, and was up all on my own the day after surgery. First few days home were rough, but only because of withdrawals from the morphine pump. I was actually able to shower the day after I got home, completely on my own (with a shower seat of course). And was even able to shave my legs lol something I hadn't been able to do without severe pain in close to 6 months.

    Now, I feel great! I have ZERO leg pain, and really ZERO back pain. I have a little bit of stiffness at the surgery site, but I can't even call it discomfort. I've already weaned myself almost totally off of all pain meds (and only take the 1/2 pill twice a day to avoid withdrawals).

    I've been back at work since this past Monday, (at week 4 of recovery. Dr actually released me at week 2 because I have an office job, but I chose to take 2 more weeks so I could get as much of my strength back as possible.) and have been driving since week 3. The only things I can't do are those within the basic restrictions (NO BLT). I'm also walking a minimum of 3 miles a day. At the end of the day I'm a little tired and stiff, but not something I'd even take a tylenol for. A warm blanket and my recliner, and I'm happy as a clam!

    I had extensive herniations at L4-5 and L5-S1 and I was in excruciating pain no matter what. After a little over a year of tons of narcotic pain meds, PT, ESI's, etc., and I still couldn't even walk to the bathroom without a cane, and some mental preparation beforehand. So before the surgery I was absolutely miserable and in excruciating pain. Talking a 8 out of 10 most days, and a 9 if I tried to do anything physical whatsoever. Surgery was the best choice I could've made.

    Hope my story helps some.
  • Thanks for your stories, fellow spineys. It really helps to hear what you went through and has helped me come up with more questions.

    Gwennie, I totally understand about taking stuff to the hospital. When I had my ACDF, I took a bunch of stuff and only needed what I was wearing when I got there. Thanks for telling me about how much help I'm likely to need and for how long. My hubby will take a couple of days off (he works in a 2-man shop, so it's hard to take off too much time) and we figure that we have some friends that can come and check on me for the following three days.

    Meydey, I had a dilaudid pump when I was there. I watched the clock every minute until I could press the button again. I'm sorry to hear about your permanent damage. I guess that's what I'm trying to avoid also by having this surgery so soon.

    Awalker, thanks for your story. It's always a comfort when someone says they'd do the surgery again if they had too, that it wasn't horrible. I can't tell you how many times I've told new neckies that too.

    What about sleeping when you get home? Is a recliner helpful or do you need to lay relatively flat?

    Did most of you stay in bed for a few days after you got home or do you need to start walking the very first day home?

    Again, thanks for the stories and experiences. All of you had much harder surgeries than I'm expected to have, so if you can get through it then I know I'll be able to also.

  • Hi Cath,

    I'm so very sorry you need to consider another surgery. It's always a difficult decision to make.

    My experience: I'd had episodes of sciatica over the years, but, this past April I had an attack that scared me bigtime because of the severity of the neurological deficits, degree of pain, spasming. After a month of trying conservative measures with no improvement, I was referred to an OSS. Xrays showed how severe the problems were, MRI/CT really confirmed it and it was strongly recommended I consider having surgery asap to hopefully avoid permanent nerve damage. My TLIF was minimally invasive, so it appears I didn't have as many recovery issues as folks that have open procedures from my reading here. Had lammies, disc cleanup, stenosis cleanup, decompressions, fusion, rods, screws, 1 disc spacer since I had a bone on bone issue w/ one disc. There was enough bone from the lammies, so I didn't need donor bone. I had surgery Monday AM (1st slot), was an inpatient til just before lunch on Wednesday and released to home. Was on an regular IV the whole time, no pain pump, if I needed extra pain med it was either given as a bolus IV push or added to the other 'ornaments' hanging off the IV pole. Had a catheter, my OSS visited me the first evening just before he was to go home, helped me out of bed for the first time and had me do my first walk. I must have done pretty well since he ordered that my catheter should be removed that night so that I could begin using the bathroom. I can remember thinking in recovery this is the first time in 3 months that my leg dosen't hurt! I also found tho' there still was some weakness/numbness that I had regained some strength in my leg and wasn't dragging it as much, I could actually lift it some and could push off my foot a little too. I had some incisional pain that wasn't too bad, but I did have horrible back spasms for the first 3 days. These finally resolved when the right med mix was found. First solid food was breakfast the next morning. Had to wear the hospital attire til discharge, and finally convinced the docs it was OK to stop using the compression booties on me since I was walking well by the second day. Those booties weirded me out for some reason when they inflated and deflated. Was lucky that I had my surgery during the Summer, so I was able to take advantage of the nice weather and do most of my walking outside. Once home, I walked whenever I could and did my stretches every day. At about 2 weeks out, I really didn't need RX pain relief any more and didn't feel I needed my cane any longer and just stopped using them w/out any problems. At my 1st checkup, I was given the OK to go back to the gym and begin light exercise w/ a 20 lbs limit. My doc was pleased w/ my progress and said I didn't need PT, just to continue walking and slowing increasing my exercise levels as tolerated. Tomorrow makes it 4 months since surgery, thankfully I'm feeling very good and hope the improvement will continue. I occasionally get a back twinge, there's no leg pain at all, foot drop has resolved completely, foot weakness/numbness continues to improve - I'll say I'm about 80% back to my norm.

    Hope this helps

  • You should be up and walking at least a little while you're still in the hospital, and continue to do so at home. Even if it's just up and around the house several times throughout the day. But I'm sure everyone will tell you that it's incredibly important as it gets the blood flowing, helps prevent scar tissues and stretches out the muscles and nerves.

    I was much more comfortable in my recliner for the first few days after surgery, mostly because the surgery site was so tender. I was able to lay in bed comfortably though with the help of some memory foam. I was fine on my side, but again the surgery site was tender so I needed the extra soft padding to lay on my back.
  • I had a PLIF of L2-L4. Was in the hospital for about 5 days. Had a low blood pressure problem so they were not giving me enough pain meds at first, but once the BP was better they were very generous with the pain meds.

    Once home I slept on my back (strange) with a thick sheepskin pad underneath me for comfort. I was able to shower myself in the hospital.

    The PT people will be rushing you out of bed to get you moving. You may want to practice log-rolling out of bed if you don't know how.

    I slept like the dead at night due to the meds but I don't recall sleeping the first days away at home. However, at the time I had a toddler who needed me.

    When is your surgery scheduled? My ALIF L4-S1 is Wed., Nov 18th. Then I will be needing a cervical fusion. Not sure when, don't want to put it off too long and risk permanent damage.

    Hope some of this was helpful to you.
  • I had such a crummy time compared to everyone, it seems like. I know I'm not the only one and there are worst cases out there. Well, I wasn't walked in the hospital at all because I was one with my Foley. The pain was the worst I've ever felt in my entire life and I couldn't get comfortable in any position. I had a terrible time with muscle spasms that the Valium had to be increased at home. I never got off my pain meds, the dose kept going up gradually and I continued to have pain flare after flare. The more I walked, the worst I felt. Sitting was a problem, standing too...the only way to feel comfortable was laying on my side in bed or on my back with my knees propped up. I wish I could have done better.

    Sorry for the self pity Cath and for straying off the subject. I guess I'm giving some extra insight on my fusion experience.

    PS Lisa, I hope your surgery goes well and that you get better too.
  • for your well wishes. I am hoping that the ALIF will be all I need, but my surgeon (who did the 1st fusion) said that it is possible that once he "gets in there" if my spine is worse than the MRI's and x-rays show, then I may have to have a 360. NOT the scenario I want to happen, of course, but I am mentally preparing for it, as well as setting up my house. Better safe than sorry.

    It stinks that you had such a rough time after surgery, but I think it is helpful to let others know because too many Drs. give a rosy picture of the post-surgery world and for many of us its just not happening.

    Cath: of course you are scared and not sure what to do. If you weren't I'd be scared for your mental health! My upcoming fusion will be my second but I am becoming a bundle of nerves!

    I know what to expect, but then I don't really. I am 6 years older from the last surgery, my fitness level has deteriorated due to Dt. & PT telling me to quit gym and yoga, so as not to do more harm to my spine.

    This time around I have different issues to deal with: a preschooler and 2nd grader. Working around their schedules will be tough, however, I have a group of other Moms who will help me. Thank Goodness (kharma, yeah!)

    At any time please feel free to PM me, both of you.
  • I had ALIF L4/5 on 10-6-09 went home the next day the first week was a little rough but with meds not to bad I stoped all drugs after first week for the most part I dont like takeing pills the hardest part for me was and still is getting up from laying position it feels like I have velcro on my back I would suggest you have someone with you at all times the first week to help you get up go to the bathroom get things for you ect...I wish you the best of luck on your big day.
  • my experience is much like yours. My surgery was Oct. 22nd and I am suffering so badly the meds really don't kick the pain, just ease it up enough so I don't feel like losing it. Now I am facing terrible constipation, haven't gone in about 2 weeks! So I am in my bed looking at a big bottle of mineral oil and container of Miralax. Nothing else has helped thus far and I have tried numerous things. I worry about this because the same thing happened after my shoulder surgery and I ended up in the emergency room with diverticulitis. I am trying to avoid that but dang this is hard! So you have a partner in suffering, believe me. I remember them making me get out of bed the morning after surgery I thought I would die of the pain. I had to drag my incision drain and catheter along with me. What a mess! I am so happy for those who have an easier time :)
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