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  • I was not even aware that this could be done other than at the L5-S1 level, but I went on their website and see that it is now being done. To the best of my knowledge, you will be the first person on this forum who has had this surgery...so I'm afraid you're not going to get much feedback about it here. A few people have had the AxiaLIF with mixed results.

    Of course, many people on the board have had lower lumbar fusions, but I think you were specifically asking if anyone had the AxiaLIF 2, right?

    Just find out how much experience your surgeon has doing this procedure...I guess it would be too early to find out what kind of results he's getting with it, since it has only been done for a year or two...

    If you are not squeamish, there are some cool videos on their site:


    Please let us know your experiences with this surgery. You can be the forum's eye-witness reporter for this new technique!!

  • jasoncamaro69jjasoncamaro69 Posts: 84
    edited 03/09/2013 - 9:08 AM
  • I will be going for a two level fusion over the same two levels in the new year, though it is not the AxiaLif. From the research I have done a two level fusion is more tricky than a one level fusion and has a lower success rate,but I have reached a point where I can't live with the pain any longer.

    That being said I would definitely phone the front desk back and say if you can't speak to the surgeon before the surgery you don't want it. From the sounds of things this is not an emergency surgery and I personally would not be happy going into such a big op with unanswered questions. Remember they are there to help you not the other way around.
  • I Haven't heard of 2 level AxiaLif surgery before but had heard that they hoped to offer it in the future.

    I have heard of success with this surgery on L5/S1 level.

    I would certainly want to speak to your surgeon and have the questions answered before the surgery. They must understand that!
    Hope you manage to get some answers soon.
  • PLEASE LET ME KNOW if you do this and how it turns out, Edited feel free to call me.

    I am going to see the surgeon on the dec. 31 who has done the most of these in the u.s. The axialif 2L is the only surgery I can do. The doctor told me due to the amount of muscle in my back they can't do a normal fusion (competitive bodybuilder) and the axialif 2L is my only option.

    I have been doing pain management for just over a year now, I can not do this roller coaster anymore of pain meds.

    I also have been quoted 50,000 Euro by the stenum institute in germany for a 2 level ADR.

    I am not sure what route I want to go. If it was a single level ADR I would go that route, but there has not been much sucess or a patient poll to really know the results of a 2 level adr....then you have the insurance issues and trying to get them to pay for it.

    so the axialif 2L might be my only option.

    The doctor who has done the most of the axialif procedures is in cincinnati. His name is Edited I even contacted the manufacturer of the procedure and thats who they even refered me too.

    **** if any of you are curious of this procedure here is a link to the animation of it on youtube..

    Post edited by Authority Member haglandcfor inappropriate language and name of Medical Professional was removed.
  • jasoncamaro69jjasoncamaro69 Posts: 84
    edited 03/09/2013 - 9:08 AM
  • if I do it, thats the guy I am going to....might be worth a trip from IL to do for you. I wouldn't let a ortho touch my back, to many nerves and everything else. Dr. Edited is a nuerosurgeon.

    have they told you the risk of puncturing your bowls yet? that sounds fun ehh?

    Post edited by Authority Member haglandc, name of medical professional removed
  • jasoncamaro69jjasoncamaro69 Posts: 84
    edited 03/09/2013 - 9:08 AM
  • ohh the axialif by far has the quickest recovery... not as much soft tissue damnage. Most patients go home the next day. surgeon even told me I could be working out again at full level withen 3 months.

    At pain management though, I have just seen so many botched fusions.

    My thought is, its hard to tell what the true success rate. I don't think some people have a very high pain tolerance and bitch about every little ache, therefor they might consider the surgery a failure. Out of all people that CLAIM back pain, only 20% get surgery. That tells me, that only about 2 out of 10 people truly have a serious amount of pain. I could not live my entire life like this.
  • First of all, ortho spinal surgeons have fellowship training in addition to the orthopedic residency, just as neurosurgeons who specialize in the neck and back have fellowship training in addition to the neurological residency, because neither residency on its own prepares the surgeon to work on the spine. Some of the fellowship programs are beginning to combine the two fellowships because they cover the same things, see patients for the same problems, etc.

    You could just as easily say "I wouldn't let a neursosurgeon touch my spine because he'll be drilling my bones and working around facet joints."

    More important is that the surgeon has fellowship training and that the practice is devoted to issues of the neck and spine, and nothing else.

    Second: It is absolutely correct that "minimally invasive" is an oxymoron.....The only thing that is different between that and an open surgery is that the approach to the surgical site is less invasive, and thus, recovery time is supposed to be quicker. However, all the drilling, cutting, screwing etc. into the bone is just as complicated and requires the same recovery.... Also, it sometimes gives the patient the mistaken idea that the surgery will be quick and easy and they'll be back to work in no time at all.

    If you read through some of the posts on this board, you will see that is not always the case. Some people end up being in the hospital longer than planned, and recovery often takes longer than what the surgeon tells you.

    If you run a search, you can read some people's experiences with the AxiaLIF. I can't recall anyone having the 2 level procedure....

    Also, remember that a fusion is still a fusion and there is no guarantee that the results will be what you want. For many people, they are...but, there are no guarantees and no way of predicting who will do well and who might have problems. Surgery is always a last resort.
  • jasoncamaro69jjasoncamaro69 Posts: 84
    edited 03/09/2013 - 9:10 AM
  • AnonymousUserAAnonymousUser Posts: 49,671
    edited 04/11/2013 - 6:45 AM
    I just did the single level AxiaLIF. L5-S1. With a neurosurgeon with a lot of experience on single level AxiaLIF. He mentioned 2 level AxiaLIF when we were talking. I never asked more about it since it was not on the menu for me. I did look at the TranS1 site at the 2 level.

    One person posted on here before about doing 2 level AxiaLIF. She wasn't complaining and said to PM her. Well she never turned on her PMs and never logged in again from what I can tell.

    I do have some comments for you Jason.

    Forget this ortho is no good only a neuro. That is bunk. Like Gwennie said. It is really their training and experience. I live in NC and am familiar with the company that makes the Axial products. My surgeon is a consultant for them. He happens to be a neurosurgeon. I went to see him because he has years of experience with AxiaLIF. He used to be the Chief of Neurosurgery at the hospital I used. He has an excellent reputation in the area.

    Tell your surgeons office that your questions and concerns have not been properly addressed. You want an appointment before surgery. Tell them to cancel the surgery and schedule for a later date. You need to be clear if you do not get time with your surgeon you will not let him operate, period.

    Get a 2nd opinion. I don't care how good you think someone is. People, including surgeons, make mistakes in judgment and analysis.

    If you have not had a Sacral MRI then I would question the surgeon. Mine explained that he had to see the angle and pathway. If you have too much curve in your tail then access for Axial surgery is a problem. I believe people with scoliosis can't be done. He told me how many degrees of curve before he would not do it. I forget the number.

    If you read through my thread I posted the link for you will see that the Axial bolt does not go in perfectly straight. Based on the curve of your spine getting those tools in. So for a 2 level that curve in your tail bone is a really big deal.

    There is a risk of puncturing your bowels. If you do an open fusion instead, TLIF, PLIF, ALIF. There is a risk of puncturing organs too. As noted above. This minimally invasive term is being used a lot. Compared to the previous approaches it is MIS. That doesn't mean you just blow it off as nothing. It hurts!!! I can promise you that.

    I'm 5 weeks out and doing PT. I feel pretty good. Sitting down still sucks. Laying down is ok but no great. Walking still feels better than anything else. I'm not a body builder so I don't have the core strength you guys have. That should help you more in recovery.

    Plan on additional hardware. My single level I still got pedicle screws and rods in the back. For a 2 level I can't imagine you not have that.

    Would I do it again? So far from what I have learned over the past few years reading lots of articles and forums. Yes. I would do AxiaLIF again. That said I am only 5 weeks out. So keep it in perspective.

    Oh and if that 69 Camaro is a 4-speed. Park it for about 3 months. My Z06 is sitting in the garage. My surgeon told me no stick shifts for 3 months. He let me drive an automatic for short trips after 2 weeks.

    Good luck in your search and decision guys.

  • I know this post is late but i hope it helps you in taking your decision.

    I had an AxiaLIF-2 (L4-L5 & L5-S1 fusion) about 8 weeks ago, and so far I think I am doing better now. I also didn’t know if it was the right thing to do, but like you said, is all about “whether or not enough is enough”. As far as me, I had had enough. I am 32 and I had been living with lower back and leg pain for about 5 years I just couldn’t bear with it anymore.

    I was very afraid about a fusion, so for 5 years I just tried temporary solutions such as epidurals (15 maybe), decompression table, acupuncture, and even an endoscopic micro-disectomy (@ L4-L5) about 3 ½ years ago. Even though some of these treatments helped a little, I was miserable all the time. So I made up my mind and decided to look for a more permanent solution. I did a lot of research, and from all of the fusion surgeries available, the Axialif is the one that made more sense to me because it posed less risk. Then, I searched for a doctor with experience in this procedure, and fortunately I found one here in the city where I live in, and I had the axialif-2 with instrumentation (pedicle screws and rods) back in Nov 10, 2009.

    I had to stop taking NSAIDs 2 weeks before the surgery and I had to take laxatives one day before the surgery (in addition to a liquid-only diet) in order to help decrease the chance of bowel tearing during surgery. The surgery was done under general anesthesia, it took about 2 hours, and I was discharged from the hospital the next day. The first 3 weeks I was under a lot of pain (from the 2 incisions made on my back to put the pedicle screws in place), but after the 3rd week I was able to stop the pain-killers I was taking (Hydrocodone). As far as the incision next to the coxys, it didn’t really hurt at all after the surgery, well maybe just as a kick in the butt for a few days, but it doesn’t compare to the other 2 incisions in the back. Now, 8 weeks after the surgery, I would say I still have about 30% of the pain that I used to have in my back, buttock and left calf. The pain is not unbearable anymore, but it is still kind of uncomfortable sometimes.

    Furthermore, I developed a few new symptoms/pain after the surgery that I did not have before. I feel a little bit of numbness (not weakness) at the front muscles in my legs, which is not a big deal, but a little weird feeling. Also, I very particular pain, kind of combined with pressure, in my lower back only when I sit down or stand up. I guess this pain/pressure is normal and expected because of all the rods and screws inside the vertebras. After all, all these instrumentation or devices are the only thing holding your vertebras together and preventing the disc spaces at L4-L5 & L5-S1 from collapsing while the morcelized bone replacing the discs solidifies and fuses. Fortunately, these new symptoms have been going away; slowly, but going away.

    Like I said at the beginning, I am doing better now and I have hopes to keep getting better little by little. Overall, I am glad I did it. If you decide to go for it, I really hope you get better after the surgery. I also would like to suggest you, that if you decide to have the surgery in other place than the city you live in, take somebody to be with you at all times to help you walk, dress up, get up, etc, after the surgery. Also, try not to travel back home right after surgery (stay a few days in a nice hotel or something) because the incisions made in the back and the pedicle screws really hurt a lot, especially the first week.

    Good luck, and I'll be glad to answer any other questions.
  • jasoncamaro69jjasoncamaro69 Posts: 84
    edited 03/09/2013 - 9:11 AM
  • Jaz,

    I did AxiaLIF 1 level at L5-S1 8-9 weeks ago.

    Regarding your new symptoms. That numbness in the front of your legs. I feel that. On the top part above my knee. The skin is also sensitive to the touch. Not so much that pants bother me. Running your hand over it does. I also get tightening in my calves. Mainly my right one. The left side is where I had all my pain before. The lower back pain it seems is the Axial bolt. I get that same pain. I have pedicle screws and rods too. Julie got a single level and they only installed the Axial bolt. No pedicle or facet screws at all. She feels the same pain we do. I'm sure the pedicle screws add to it though in our case. Those suckers are in deep.

    I still have some numbness in my left foot that comes and goes. It used to be there all the time. We're not sure if it will go away or if I also have some small issue at L4-L5. Still have some Piraformis pain but not as bad as before. My previous back pain is gone. Previous IT band being locked has stopped. Still have some pain from it.

  • Jason,

    While I did single level. The 2 level is not that different. An extra pair of pedicle screws, longer rods and bolt. Same process. I don't think our recoveries are that far apart after reading Jaz's post.

    To answer some of your questions from my experience.

    I returned to work for 10-20 hours after 4 weeks. Then took almost 2 weeks off. We close at Christmas week so it just worked out lucky. I will work 20 hours/week through January. Full time starting week 12. I'm a desk jockey and can and do work from home. So I login at all hours of the day and night to do work while laying down on the couch. If you have a physical job I suspect your physical limitation of BLT and no more than 5-7lbs of weight will stop you.

    Yes I woke with a catheter. When you go in for surgery you will get one. Plan on it. They removed it when I woke up and was coherent enough to move. Maybe 8 hours after surgery. They got me up and made me walk. I went and pee'd while I was up.

    L5-S1 doesn't affect range of motion much. So for me no. For you I suspect so. L4-L5 does move a lot more.

    I started PT after my week 4 visit to surgeon. First couple of weeks of PT wasn't fun and didn't help. Now it is starting too. Get pool/aqua therapy if you can combined with land therapy.

    There is no real comfortable position to sleep in, sorry. I toss and turn. It all feels about the same to me.

    Size of incisions. Did you read my thread on my surgery? I posted in there or the other thread that noseovertail started called "Pictures". I posted a picture of my cuts. You'll have about a 1" incision in your butt by your tail bone. And your butt will be black and blue after. Not really painful. I got 2 - 2" incisions in my back where the rods/screws go in. Since you also need the next level. Plan on the incision being at least 3" on each side. Your tattoo looks cool. Based on what I can tell. The soldier holding the base of the flag pole is gonna get cut. The left tower of the WTC is also gonna get cut. My cuts are stitched inside but the outside is glued. If your surgeon is nice he will try and line the skin up so your pictures are even. My wife says after 9 weeks I still have visible scars but they look pretty good. So maybe you'll get lucky and only have a small white line where the incisions are.

    Your other questions.

    You should have gotten the surgery packet when he told you was doing an AxiaLIF. Honestly we've told you about everything you would find in that packet, and more.

    As I told you in the other thread. You should have a Sacral MRI done if you haven't already. Unless he has past MRI where he is comfortable that he has a good entry angle.

    You should see your surgeon 2 weeks pre-op to go over any issues or concerns. That is also the time where he would tell you to stop any medications or vitamins he does not want you taking. NSAIDs and any blood thinners being a really big deal. Then 1 week pre-op you go to the hospital and do the pre-op test. I got cardiogram and blood tests. Had recently had urine test with my primary so they took his results. So plan on that too. Then go over all medical history with nurse. Then the anesthesiologist will come in and talk to you. As long as nothing bad comes out of those tests you are on. Show up the morning of surgery and git-r-done...

    For the single level they released me the next morning. It's written up as day surgery, 23 hour stay. Makes the insurance company happy. I was fine going home the next day. Staying there was pointless.

    I had a brace. Wore it for 2 weeks a lot then weened off it. You may or may not get one. That is up to your surgeon.

    My surgeon came in to see me before I got discharged. Made sure I was ok and ok with going home and gave me RX for meds.

  • jasoncamaro69jjasoncamaro69 Posts: 84
    edited 03/09/2013 - 9:11 AM
  • I don't think you'll notice much loss of motion with a fusion from L4-S1. Perhaps it depends on how limber a person is to begin with...I don't really know. I'm fused at L4-5 and it is not at all noticeable to me. L5-S1 is pretty solid to begin with, in most people, and there is little movement. I don't feel that my movement is restricted except that I cannot bend backward as far as pre-surgery.

    Regarding sleeping positions: you need to learn to sleep in the positions that are best for your spine. You may have to learn some new habits and postures to keep your surgically altered spine well and healthy.
  • SpineAZSpineAZ WiscPosts: 1,084
    Often they will take the catheter out while you are still sleeping right after surgery. If they leave it in they pull it out a day or two after surgery. It's uncomfortable but not painful (my hubby recently had surgery and was worried about this but found it was more of a weird feeling than a pain sensation when they pulled it out)
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Jason,

    Answering your questions:

    When were you able to return to work?
    The doctor did not put me any restrictions about when going back to work. I think it all depends on how you feel. In fact, the anesthesiologist told me right before my surgery that he also had an Axialif a year ago and that he went back to work the next day (whether that is true or not, I don’t really know, I find it hard to believe, but who knows). In my case, I have not yet returned to work. I have a desk job, so I don’t feel quite ready to be seated for 10 hours straight everyday. It is the position that hurts the most, so I think I’m going to take a few more weeks before I go back. I just want to make sure the morcelized bone inside the discs have enough time to fuse or to solidify at least. Better safe than sorry, I do not want to go through this ordeal again any time soon in the future. As far as lifting things either at work or at home, the doctor told me not to lift anything heavier than a gallon of water for at least 12 weeks.

    Did you wake up with a catheter?
    Yes, I did wake up with a catheter. I didn’t know I was going to get one, so it was kind of a surprise to me when I woke up (fortunately, they put it in when I was asleep). The thing is that when you are under general anesthesia you loose control of your physiological functions, so you have to get one of those, either to prevent you from peeing at the surgery table, or to make sure the urine comes out of your system since it can be very harmful to your kidneys if your bladder fills up and you don’t urinate. They can remove it a few hours after you wake up from the anesthesia, but in my case I didn’t feel well enough to stand up and urinate in the bathroom, so I told them to leave it there until the next day when I went home. I think it should be the least of your worries; it doesn’t hurt, it is just a little uncomfortable; only when they take it out it stings a little bit.

    Do you feel a lot stiffer afterwards (the segments fused together)?
    Right after the surgery (maybe the first 2-3 weeks) I felt very stiff and with a lot of pain from the incisions in the back (the muscles were very swollen). Once the pain started going away and the muscles became less inflamed, I started gaining flexibility. I really don’t feel much difference than before the surgery, although I really have not tried to do anything that requires that much flexibility yet. In fact, even if everything fuses well (hopefully), I have to be very careful and not do anything that puts too much stress to the remaining discs in the lumbar spine since it is going to be 3 discs doing the job of what 5 discs used to do. Before the surgery the doctor told me that for a one-level fusion, the change in flexibility is not noticeable or negligible, and that for a two-level fusion I would barely notice it (unless I was an Olympic gymnast).

    Have you started PT yet?
    The only PT that my doctor recommended is walking. Since the second day after the surgery, I walk for about 15-40 minutes everyday.

    What position was most comfortable to sleep in for you?
    In my case, I find it more comfortable to sleep over my stomach, although it is hard to sleep all night in that position.

    How big were your incisions in the back, and did your Dr. tell you ahead of time that is what you will get?
    I got exactly what the doctor told me. That is two 2-inch incisions in the back (about 1.5 to 2 inches away on both directions from the center/middle of the spine) and one about 1½-inch incision next to my tail-bone (right-side) and which is not visible. It is a really cool tattoo the one you have, and I hope it doesn’t get messed up that much.

    I hope this answers help you. Let me know if you have any more questions, and don’t forget to post after your surgery to see how you are doing. I will be checking for posts everyday.
  • Graham,

    Thanks for sharing your experience. It is good to know that both of us have similar outcomes and recoveries (I hope it means everything is going well and according to plan). Please keep posting about how it goes for you.
  • Like Jaz said you will get one and you do need one while you are in the OR. I knew I was getting one so it was no surprise. When the nurse pulls it you get this funny feeling and irritation. For all of a few minutes. Then it's done. You're not alone with the phobia idea. I think most guys don't ever envision something going up that tube!!! It's there to expel fluids only ;-)

    That said when all this back pain was going on. I had leg pain and partial numb foot. I also had internal issues. Both over active bladder and ED. The bladder was more about urgency and not emptying properly. The ED was random. Some days things worked. some days not.

    Considering I just turned 50 at the time my primary sent me to a urologist. Neuro agreed I should see him also. The urologist said part of it was age on both counts. We were not sure how much was also related to the nerve impingement(s). He gave me pills for both that helped. Since the surgery I'm now feeling less issues in both areas. Have to see the urologist later in the month to do some more tests. I can assure you a catheter is nothing compared to some of the tests a urologist will do!

    So don't sweat the catheter. At the time it is there you'll be glad it is. A couple of minutes of discomfort removing it is nothing.

    If either of you guys have had problems with internal organs, including bowels too. Some of that may clear up as you heal. The nerves in that part of your spine affect them.

    Jason I'm sending you a PM with a link to a couple of PDF files on my surgeons website. 1 is Do's and Dont's pre-op. 1 is a laxative schedule for pre-op to empty your bowels. You want it completely empty before you go in. It will reduce the chance of getting nicked during surgery and it make it easier on your surgeon. Your bowels are partially in the way for axial.

  • jasoncamaro69jjasoncamaro69 Posts: 84
    edited 03/09/2013 - 9:12 AM
  • Everyone else already said everything that I would have, but I wanted to chime in and say that what gwennie said above "You could just as easily say "I wouldn't let a neursosurgeon touch my spine because he'll be drilling my bones and working around facet joints." is such a good point that I wish it could be a sticky. People on this site keep knocking down orthopedic surgeons but some of them are wonderful, just as some neurosurgeons are great and some are not. ; )

    JasonCamaro, I hope your surgery goes well & you wake up in as little pain as possible. I too was terrified about the catheter but post-op I was SO glad they left it in for a couple of days. It's hard to get up & out of bed whenever you have to pee.

    Oh and also, if you check out the "Pictures!" thread, you'll see one user who also has a back tattoo and her doctor actually worked carefully to make sure it all matched up when he was finished with her surgery. I thought that was awesome, you may want to bring it up to your surgeon as a concern of yours. You never know, he may take the time to make it all look perfect when he's done.
  • Hi there,
    I feel really horrible that you are going to do this surgery. My husband did it Exactly one year ago. It was the worst thing we have ever done. The produre is been shown to not have good results. The fusion never formed, it was like putting a loose hardware in there.
    He was is so much more pain than before. He had to quite work and have another re-do surgery to try and repair the damage.
    There are so my patients that if you read enough on here that had the same horiable outcome as we did.
    We had numerous conversations with Trans 1 about our outcome and I hope this gets pulled from the market.
    please please get more help before you go with this.

  • jasoncamaro69jjasoncamaro69 Posts: 84
    edited 03/09/2013 - 9:12 AM
  • jasoncamaro69jjasoncamaro69 Posts: 84
    edited 03/09/2013 - 9:12 AM
  • Does your incision get into your tattoo?
  • jasoncamaro69jjasoncamaro69 Posts: 84
    edited 03/09/2013 - 9:12 AM
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