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AxiaLIF L5/S1 fusion recovery

JuileJJuile Posts: 24
edited 06/11/2012 - 8:40 AM in Back Surgery and Neck Surgery
Thought I'd post to see if I could both help others about to have this, and also see if anybody else out there can help me. I'm nearly three weeks post operative. I'm home, wounds healed well, I'm walking and feeling pretty good, but I still have lower back pain, plus sciatic pain. I know I'm being impatient, but was wondering if anybody out there has had the same surgery and found time made the pain go? All the surgeons will say is it will take time, but I'd love to hear from anybody out there who has some first hand experience, whether positive or negative.
+ if anybody out there is having this surgery and wants any info feel free to ask me. I found it hard to find much out before I had it, so am happy to help.


  • Hello, glad you are starting to feel a little better. I will be having the same surgery (2 levels, though) in a few weeks. How long did the actual surgery take, and how long did you stay in the hospital?
  • Hi Jason,
    I was in hospital for 4 days, but am in the UK, where this procedure seems to be very new so am not sure if it's the same if you're US based. I'm not sure how long I was in the operating theatre for, but about 3 hours I think as I didn't get back up to the ward until mid afternoon and I was operated on in the morning. They kept me in recovery for quite a while as my BP hit the floor, though that's pretty normal for me. I stood that night and walked easily next day. By the evening of the day after the op, I was easily meandering round the ward corridors.

    Worst part was most definitely the 'bowel cleansing' drugs they gave me pre-op to clear my system - they do this incase they nick your bowel, which is a risk due to where they go in, but it meant 24 hours of the runs, which is no fun when you're nervous and your back aches..!

    Drugs after the operation were a bit of a pain for me too, as the anaesthetic and/or the morphine made me very nauseous. I had morphine straight after the op, but once I was back on the ward that finished and I stuck to Codeine after having another bad reaction, though this time to Tramadol. Now I'm just on Paracetemol and Ibuprofen during the day, though I still take half a dose of Codeine at night. But at not yet three weeks post op, I think that's pretty good.

    Basically I'm not sure if the surgery has worked or not as I'm still very sore, but the recovery in terms of being able to walk and move about is okay. I feel tired, and it's hard to sit due to where they made the incision but that's getting better day by day.

    I really hope it goes well for you Jason. You'll have to let me know. What I would say is ignore the website that promotes the procedure - I really do think what they say is unrealistic, and from the few bits of web feedback I've found many others agree. It is better than traditional fusion in terms of recovery, but it's not a small op and you will be in pain afterwards. Just expect that and then you'll be relieved to find you can walk! For me at least it's been none too bad.

    And if there's anyone else out there who is like me out the other side, please post. I could do with some reassurance that the pain I'm in now might well go in time...
  • Thank you for the reply. 4 days seems like a long stay in the hospital. I suppose as long as I can eat a normal diet, I should stay pretty mellow. I turn into a different person if I am stuck in the hospital with a restricted diet.

    Hopefully I will still feel like blogging on here about it afterwards. You never know if you will feel like trying to form thoughts and type them onto a laptop :)

    I will definately post updates on here, though. Glad to hear you are still moving forward all things considered.

  • AnonymousUserAAnonymousUser Posts: 49,671
    edited 04/11/2013 - 5:15 AM
    Hey Julie,

    I agree with most of what you said. You can read the thread above about my experience. I am 8 weeks out. My back still hurts deep inside. Doing PT now and the added exercises make the muscles hurt. You need more patience, and so do I. 3 weeks out it is supposed to hurt. You are also correct on not paying attention to the marketing. Minimally invasive surgery does not mean it doesn't hurt. It means you will recover quicker than a traditional surgery.

    Good luck.
  • Really helpful to read your thread. Cheered me up to hear you're sounding so much better though not great that you're still in pain. In a way though it helps me to hear you are in pain, as that website which promotes this procedure makes it sound as though you should be running marathons at a few days out.. I didn't ever believe it, but it does make you worry it hasn't worked when you're sofa stuck with no energy.

    Interestingly we have different amounts of hardware - I have just the single axialif screw joining the vertebrae and no extras. My surgeon says he'd rather be as minimally invasive as possible and see if that does the trick. His logic was that as I'm quite slight, and have managed to keep relatively fit it was worth a try, as in his experience it's often the extra screws that can cause more problems. He's warned me I might need some more screws like you if it doesn't fix it, so fingers crossed. Also I'm not allowed to do anything much other than walk for 6 weeks - certainly no PT. Interesting how they all approach these things differently.

    + I do so hear you on the meds nightmare - everything made me throw up too, then I got a plague like rash of hives all over my body. I feel far more sane now I'm on lighter drugs. Am hoping I can work towards doing without anything over the next couple of weeks.

    I'll keep an eye on your thread for updates. Thanks again - hope you continue to feel improvement. I'll keep my fingers crossed for you.

  • Just thought I'd say that the four days was probably because I'm in the UK. They're new-ish to the Axialif and maybe more wary.

    I didn't feel like eating after the op for a couple of days as the drugs made me feel sick - just unlucky I think. Also they must have stuck tubes down my throat, because it closed up making eating nigh on impossible. Best ask what they're going to do then you'll know. You'll be so pleased to be through to the other side though, and excited by being able to move that you won't mind missing a bit of food am sure.
  • SpineAZSpineAZ WiscPosts: 1,084
    Actually the UK tends be be more generous in how long they let patients remain in hospital. In the US they try to push you in one door and out the other even for major surgery.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Jason - just to warn you - the meds really messed me up post-op and they kept me in the hospital on a liquid diet for over a week. I did have complications though, so my experience is not typical.

    Juile - glad to know you've found someone else who has had the AxiaLIF. I've read Zo6's posts too. Intriguing procedure, I hope it really works out for you all.
  • Julie,

    Well if you have the same deep pain in the middle that I have. I think we can deduce that it is in fact the Axial bolt doing it. Since I have added hardware but you don't. It would make sense. While the pedicle screws go deep and do hurt. The surgeon drills a good size hole through S1 and into L5. That Axial bolt is a lot bigger (fatter) than a pedicle screw. I saw one of the bolts in his office. He showed me all the hardware when we talked pre-surgery. He was also very clear that bones give you a deep seated pain when someone drills into them and sticks screws in them.

    My surgeon was dead set against only facet screws in the back. He said all his earlier failed outcomes were from facet screws. He ended up going back in and doing the pedicle screws with rods. He never mentioned just doing the Axial bolt alone. The Trans1 site does not show that as an option. I was told that added hardware was for support that the original design does not give. He said since he went to pedicle screws with rods he has had no failures or revisions.

    Your surgeon is taking the minimalist approach and makes a valid point. If more hardware is not needed then don't. I hope he is right.

    Please continue to post and document your outcome. This procedure is not commonly know. That is why I started documenting mine. So others who search can find it.

    Good luck!!!

  • Graham,

    That's reassuring that your deep ache is similar and also that your surgeon says it's normal. The trouble I've had is that the Surgeon didn't decide I should have the Axialif until the day before the operation, so though he'd mentioned it as an option before I'd thought I'd be having the more traditional fusion, so had little time to research. I knew it sounded good and most definitely worth saying yes to, but there was little time to ask questions, so your experience is like gold dust to me.

    If I do get to the stage where they decide I need more screws I'll question using facet screws and ask about pedicle ones with rods - that's really really good information. Am hoping my Surgeon's instinct is right, but who knows.

    I will keep posting. Hoping it helps others, just as you're helping me.

    Thanks again and Happy New Year!

  • You're right about the UK allowing more time in hospital. Possibly it's because of our NHS system. It's infuriating in many ways as you have to wait, but then again we don't have the insurance nightmares that you can have in the US.

    It's intriguing us all over here what Obama's trying to bring in in terms of public healthcare. We do so love our NHS and it's amazing to think I've had all my care without paying a penny extra to anyone other than my normal taxes. Be great if you could find that somehow in the US.

    Hope all goes well for you when your day comes!
  • To Julie,

    I considered sending a PM, but think this is such a 'hot topic' it merits being posted on the board.

    In your last post, you stated that, 'we do so love our NHS'. With all due respect, I'm wondering who 'we' is, because I, for one do not 'love our NHS'!

    Let me explain why I feel like this: having worked in the NHS for the better part of my life, when I became a patient, I saw the other side. I've been in hospital in the US and in the UK and have used both the NHS (free) and SPIRE (not free).

    In terms of standards, level of care, cleanliness and almost every other issue, I can say without hesitation, that in my opinion, they rate in the following order:-

    1) US
    2) SPIRE
    3) NHS

    When I worked in the NHS, we used to watch cockroaches running around the corridors; when I was a patient I left a small piece of cotton wool (close to a prominenet cleaning area) at the start of my 4-week stay where it remained the entire time; a regular UK user of this site cleans their hospital bed on each admission and says the beds are filthy; having finally managed to control MRSA (methicillin-resistant Staphylococcus aureus), there is now a new super-bug, C. dif (Clostridium difficile) which causes fatalities. I was one of the lucky ones to become infected with this in an NHS hospital and feel lucky to have survived it.

    Therefore, with no disrespect intended, please don't include all of us in statements about the NHS. Given a choice, I would preferentially use the current US system or SPIRE and since acquiring C. dif, have done just that.

    The one good point about the NHS is, it's free and whilst I'm not decrying that as important, I'm just not sure whether it's the panacea made out to be, by some. The system used in Switzerland seems to far outweigh the UK's NHS.
  • Hi Val,

    Apologies as I didn't mean to make it sound as though all feel the same way I do. As a rule though, I think the majority in the UK do love the NHS. In polling it always comes up as something we value most.

    The obvious difference is that in the US you have to pay for healthcare on top of other taxes. Many Americans are under insured or not insured at all, so have no access to services which in the UK find are available to all. For me that's the bottom line and many American friends living over here have said similar. One friend for example has just had a minor operation that he simply wouldn't have had in the States as he had insufficient insurance.

    Another example; I have an Uncle in Colorado who like my own father is suffering increasingly from Arthritis. My father in the UK is under a specialist clinic, regularly monitored and has his treatment regularly reassessed to ensure he's as pain free and mobile as possible. Last week he had a minor operation to increase his circulation. All of which is free on the NHS. In contrast, my Uncle in Colorado has similar problems, but minimal healthcare cover. The knock on is that he has limited access to the drugs and therapy he needs. Both men have worked and paid taxes all their lives, neither especially well paid, hence my Uncle's low cover. It's hard to hear his movement and life quality is decreasing so rapidly in relation to my own father. And all because of a different healthcare system.

    And one final personal example is that I doubt I'd have had the operation I've just received in the States. Many on here based in the US say their insurers are blocking Axialif - so even if I'd paid sufficiently I may not have been one of the lucky ones.

    I do hear what you say, and I'm really sorry to hear you view the whole system here as sub standard. I've been lucky perhaps, but having said that several friends have had operations over the past few years - I've already mentioned my father, but my mother too is now in need of relatively intensive medical care, and she too has received only excellent attentive care. I'm not saying there's never a grumble, but none of us have had the problems you've suffered - certainly not a cockroach in sight!

    As to MRSA and C-dif, it's big news over here. I was screened before I went into hospital to see if I was infected. I'm sure you know lots of people carry it without realising? Elective patients here are screened before they're allowed on a ward, and isolated if they're found to carry the bug. All emergency admissions are instantly screened too. I found that once in hospital the precautions where I was were immense, the facilities spotless and they had zero infection rate on my ward at least, so maybe things have improved since you were sadly so ill.

    Out of curiosity I checked MRSA in the US, and it's wide spread there too. 1.2 million hospital patients were infected over a year, so it's obviously not just a UK/ NHS problem. Same with C-diff. it doesn't take much Googling to discover it's widespread on both sides of the pond. I'm not at all saying this to underplay or diminish your experience in the UK. It must have been awful for you to be so ill. I'd never underestimate how dangerous that can be. I hope you're totally recovered now, I really do.

    So thanks for replying Val. Of course you're right the NHS is very far from perfect and yes arguable we could learn from a system like that in Switzerland. Did you realise that there they have a compulsory insurance system, so it's not exactly a true comparison. Although all have access, it's a mixed system. Interestingly with the ageing UK population and consequent increased costs, it's one our politicians are talking of adopting to maintain the NHS.

    Simply though (after a long ol' ramble!), for me the NHS has worked brilliantly and for many of those I know too. I still think free healthcare for all is a major plus and far fairer. I'd put up with a fair amount to keep that.

    Thanks for chipping in though. Feel free to argue back!

  • Juile said:

    And one final personal example is that I doubt I'd have had the operation I've just received in the States. Many on here based in the US say their insurers are blocking Axialif - so even if I'd paid sufficiently I may not have been one of the lucky ones.

    Where did you come up with this? Many on here? There have been barely a half dozen people post about AxiaLIF period. That isn't many. That is why I started my thread to document it.

    Who and which insurer is not supporting it? I had AxiaLIF and I did not pay for it, coerce or arm twist my insurance. My surgeon did a pre-op qualification. It was approved with no issues. A formal "open surgery" to do a TLIF would have cost my insurance company more money from beginning to end of recovery. The Axial hardware is not cheap. But easily offset by the reduced surgery time, hospital stay, recovery time, etc.

    The biggest issue I see with insurance here is ADR. More often than not insurance companies snub their nose at it. The most ADRs seem to be done by people on WC. Which really surprises me.

    Not to start an argument but I've read a fair number of your fellow UK posters complain about the NHS. Also the Canadians complain about their NHS equivalent.

    I did send Val a note. I think this should be posted in the Health Care section. I started one on ObamaCare as I call it. The US HealthCare system he wants to create. While some say they don't want to talk politics on here. Health care is a major issue that faces all of us regardless of which side of the pond we live on.

  • Hi Julie,

    I was pleased to see your initial message as I am due to have posterior spinal fusion L5/S1, decompression and disk replacement on Sat 9th Jan at the Spire in Bristol, UK. Despite reading up I still struggle to find personal recounts of the experience and of what people wished they had known before they had gone ahead with the procedure.

    All I understand of the procedure is that the disc will be replaced, an "H" pinning and cage will be put in place and that I will be in hospital for 5 nights.

    As far as procedure descriptions go for UK this link appears concise https://www.ianjharding.com/

    If you have any advice, it would be warmly welcomed as now becoming highly & extremely apprehensive.

    Best regards, Aunty Roo
    Cervical facet joint syndrome
    C5/C6 Partial Disc Protrusion
    Lumbar Isthmic Spondylolithesis L5/L6
    L5/L6 Disc degeneration
    Lumbar Facet Joint Syndrome
    3 x Cervical Facet Joint Injections
    1 x Lumbar Facet Joint Injection
    1 x Diagnostic Nerve Block
    1 x Lumbar Radio-Frequency Denervation
    Numerous painkillers
  • Hi again Graham -

    Sorry you're right, the wording's of my post is misleading; I meant on the internet as a whole. I noticed various posts/ links as I was trawling for info on Axialif. Simply people saying their insurance companies vetoed it for them, but it's more than okay to tell me I'm wrong as you know far more than me about the US system (obviously!).

    That though was a teeny part of my post. Basically I'm sure you're right as I know the US system works amazingly for many. My only real position is that as it isn't accessible to all simply because of who pays what, that's far from fair. And that's why I love the NHS. You're right lots of people do moan about it, and as I said in my earlier post it's far from perfect. But I couldn't not respond to Val as I've had nothing other than great care, so wanted to just say that really. That's all. Purely subjective. But you're right this isn't the place for the debate. Really I was only answering Val though.

    Hope you're continuing to thrive. I'm feeling a bit sore today, but none too bad considering I'm not yet four weeks out of surgery.

  • Hi -

    I've not got time now to check that link, but will later and reply I promise. It sounds as though you're having something different to me though, as I didn't have ADR, just fusion and my fusion procedure has been different to what you're facing. I'll have a read and a think and get back to you though, I promise.

  • Hi Aunty Roo -

    I'd love to help more, but reading your post, I think your surgery must be quite different to mine. I've just had my spine fused using a procedure called Axialif. It's an anterior interbody lumbosacral fusion at L5/S1, so the result at that level is the same as for you (ie fusion), but the methodology is completely different.

    In my surgery the incision point is a lot lower than yours will be. My Surgeon drilled upwards from the base of my spine, literally through the vertebrae. He then removed the few fragments of disc that I had left and fused to the next vertebrae using one screw, around which the bone graft will grow leading (hopefully!) to permanent fusion.

    In contrast your surgery will involve a higher incision point, then more pins which will hold the bone whilst fusion occurs. You must also be having the next disc up replaced? So that again is different to me.

    Am racking my brains to think what to say to help, but my only advice really is to ask lots and lots of questions of your Surgeon. Make sure you're completely aware of what he's doing and that you're happy with that. Also ensure (though I'm sure you already will have) that he's experienced in what he's about to do. Have confidence in him (I'm sorry to assume it's a he, but they do all seem to be male!) and that will go along way to the positive frame of mind that you need to go into hospital with.

    Another thought, but have you searched on this forum for other fusion stories which are more similar to your type of surgery? Far more people have the type of fusion that you're facing than the one I ended up with. If you can't find any that match, then maybe start a thread like I did and see if anyone out there has had the same as you're about to? I've found it ever so useful just to speak to others.

    Let me know if I can help in any way though Aunty Roo. Sorry I'm not a better match. And GOOD LUCK. Try not to be too nervous. Just be glad you'll soon be out the other side and recovering.

  • Hey Julie,

    Interesting on your findings. While I was searching for info on AxiaLIF I didn't find much about denials from insurance companies. I used several different search engines instead of just using Google. You just don't find much. So it is a learning experience for both of us. What I did get is some real life people who had the surgery done by the surgeon I used. One of them is a good friend of my mom's. So I got straight answers and no hype.

    My insurance is one of the better ones. So I rarely get denied anything. ADR is the one hot button though. They emphatically say NO. They have until I believe 2011. Then the 7 year BS excuse they use on anything considered new expires. ADR was approved by the FDA in 2004 in the US.

    For some reason things like AxiaLIF are considered more process with a twist on the hardware implementation. Where ADR just causes the panic button to be hit.

    Week 4 huh? That is becoming a faint memory ;-) Keep on following the simple rules. Don't sit so long. Get up and walk often. Even if only little bits. It adds up by the end of the day.

  • Thank you for getting back to me so quickly, much appreciated. Finally making contact with someone in a remotely similar position helps a great deal.

    Best regards, Aunty Roo.
  • I got overly optimistic yesterday and spent a couple of hours at the computer. Bad idea! Last night I was in a right old mess. That screw most definitely was letting me know it was there. From now on I will stick to your very wise simple rules..

    Glad you've got a strong insurance policy. It's really interesting to hear about the 7 year rule. Would you have qualified for a disc replacement rather than fusion? I couldn't have it as the disc was so corroded there was insufficient space.

    Hope you're continuing to do well. Let me know either way.

  • Feel free to post again or ask more. Honestly I think you're in the worst place now. The worry before is far worse as you can't do anything other than wait. Once you're through you can focus on recovery.

    Good luck to you from me. Let us know how it goes when you're able to.

  • Thought I'd log back in and say how I am. The most amazingly positive breakthrough happened a couple of weeks ago, as suddenly I was pain free at night. I've been used to waking at 3am in a lot of pain and discomfort, so losing a lot of sleep. One night I realised I wasn't in any pain. I thought it might be a blip, but it's stayed the same, which is obviously totally and utterly brilliant.

    The not so good side is that what I can do in the day is still very limited. I can sit for a lot longer and have started doing some work, which feels really positive. I can also walk a few miles, but still need to lie down as soon as I've finished (I could walk well before the op, but now am in more pain afterwards). Still though the fact I can still walk well feels positive.

    The nerve pain's no better and in some ways it's worse as it's shifted from the ball of my foot to the toes, and is incredibly sharp and intense - certainly far sharper than I've had before the op. Am hoping it's the nerve stretching out and finding the space again. Fingers crossed on that one, as I know it can take a while.

    The thing that worries me though is that my back's so sore and fragile. I've just been playing with my young son - not much, just rolling a small soft ball back and forth gently in the bedroom for two minutes. And I had to stop as my back aches like crazy. Friday I drove for the first time and that was a big mistake too. I was in quite a lot of pain all weekend. In other words, I'm finding there's not much I can do before my back tells me to stop. Am trying to stay positive - after all it is positive really. And it is still only a few weeks ago that I had the operation. I think I have to be patient - so hard though. If only I knew in say six months time that I'd be feeling lots better I could be patient. It's the not knowing I find tricky!

    Hope everyone out there's doing really well. And as ever if anybody out there's about to have Axia-lif feel free to throw questions at me.
  • Duplicate post removed

    Ron DiLauro, Spine-Health System Administrator 05/10/10
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