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ALIF+PLIF to help with my pain?

ryanwrryanw Posts: 4
edited 06/11/2012 - 8:42 AM in Back Surgery and Neck Surgery
Here is my diagnosis: Spondylosis at L4/L5 L5/S1
Spondylolisthesis grade 2

I did 2 years of radio frequency abrasions (RFA). They work wonderfully. In December I went in for my RFA and they were unable to get stimulation and after many try’s that day and many try’s another day they did the RFA anyway. I got no pain relief from that. So i was referred to an Ortho Spine DOC.

I have had 2 visits with the PA and will be meeting the surgeon in about 3 more weeks. They are suggesting that I will benefit from: Anterior lumbar interbody fusion (ALIF) and Posterior interbody fusion and instrumentation (PLIF)

I am very tired of living with back pain but Im afraid that Im too young to start with this surgery Im 30.

If I decide to go ahead with the surgery what will be my downfalls 5-10 years from now?

Is there anyone out there who has been through this to give me and idea of what they went through?

Is this a good decision for me? I don’t know I thought I wanted the surgery until they told me everything that I would have to be going through.

Thanks for any responses.



  • I don't know if you have been reading on the board for awhile, but there are many threads concerning lumbar fusion.

    This is major surgery and involves a long recovery. It is usually done after all conservative treatments have been exhausted or failed.

    It is always a good idea to gather several opinions from different spinal specialists. If you are currently seeing an orthopedic spine doctor, you might want to get a second opinion from a neurosurgeon, or vice versa.

    It sounds like you will be seeing an orthopedic surgeon for the first time. I'm curious who was giving you the radiofrequency ablation treatments?

    What other treatments have you had? How long have you had whatever symptoms that brought you to the doctor in the first place?

    There are many articles on this website regarding lumbar fusion. For some general information, follow this link:

  • Hi Ryan and welcome! This forum is wondeful, full of knowledge and support.

    Everyone one is different and every situation is uniquic, but I can tell you my experiences.

    My husband had a L5-S1 fusion 10 years ago and he is doing great. He doesn't have any limitations or pain.

    I am almost 4 weeks post op having a L4-5 anterior and posterior fusion which they refer to as a 360. It's not easy but it is definately doable. Feel free to ask any questions and we are all here to help and support!

    Again, welcome. Shari
  • Welcome to SH Look at the postive side if you are a surgical candidate. Maybe being young and a good surgeon will give you good results. You could end up pain free or with minimal,very tolerable pain levels compare to you have now to enjoy many good years of living. Some of us were just barely existing before surgery or didn't have a choice becuase the pain was so severe there was no going back so you, and only you, can make the decision to have surgery or not. You can decide by getting as much info before visiting the dr so you are informed and have all your questions answered regarding pros/cons for you. It's a hard decision and I wish you the best as you decide what you want to live the best life possible. I'm much older than you and didn't have a choice but I would do it over again! And yes, recovery is a long haul. Good luck! If you have any questions let us know because there are many here with so much experience. Take care!

  • Shari,
    I want the surgery, but the things that are really confusing me are: My wife is pregnant with our 3rd child, and she is having a tough pregnancy. So she really cannot afford to be without my help yet alone take care of me. Im about to be medically retired from my current job. So I will have to start a new career. So, if I get it done now I should be able to rehab well before I loose my full paycheck and I won’t have to get a new job and then have to take 2-6 months off from a new job. (Ill just get fired)
    Im glad to hear that your husband is 10 years post op and doing well. Im just worried that Im too young to have it now, on the other hand Im sooooo tired of living this way now.
    Good luck recovering from your surgery. I wish you the best.

  • It is hard for me to get a second opinion. Unless, I am willing to pay out of pocket for one. I have had pain now for 8 years. Every year it just gets worse and worse. I have tried all other treatment options and the RFA worked for a few years but finally stopped working. My RFAs were done at a pain clinic in the hospital. I will be seeing the surgeon for the first time but, I have seen his PA a few times. As for other treatments i have had Epidural steroid injections, of course the RFAs, PT, Acupuncture. In the last 2 years my anterolisthesis has gone from a grade 1 to a grade 2. I can no longer hold my daughters for longer than 2-5 minutes.
    I wish I was a candidate for the disk replacement but since I have 2 levels that need done, and the grade 2 anterolisthesis, they both put me out of the running.
  • Ryan,

    As others have already mentioned any back surgery is serious stuff.
    You asked about 5-10 years down the road. How you do depends on what they do, how you heal, what type of activities you do for the next 10 years, and how well you take care of your back going forward. Don't let anyone kid you into thinking that once you have the surgery you are good to go. Most likely you will be doing back exercises for the rest of your life in order to keep the core muscles strong. Each of us are different so while some may say they are great after this type of surgery others will say they are not.

    You really can't go by what a PA says about your back. They are not the ones that have a Dr. after their name along with all the training that goes with it. It would be like having a service writer at an auto dealership tell you your car needs a new engine without having a mechanic look at it first. PA's are great and they are knowledgeable but they are not the DR.

    I wouldn't ever consider only having 1 Dr. tell me surgery was needed without getting at least 1 or 2 other opinions. It seems all the Dr.'s have a differnt take on what may or may not help you. What would happen if you got another opinion and the second Dr. gave you compelling information saying something less invasive and risky would help you out. I paid out of pocket for 2 opinions after I was told I needed surgery. One of them cost me $450. I am not wealthy. Once you have a fusion there is no going back. There are lots of people on this forum who wish they had done more due diligence prior to having surgery or surgery with a particular Dr.

    As far as a 360 fusion there is a lot of info on this site about/from people who have first hand experience. I had it done in the middle of Jan. this year. It is a hard surgery and the recovery time is long. You are about half my age so you should bounce back quicker then I will. I would never have another fusion done without having the disk removed and a cage with matrix put in its place. This my opinion based on experience.

    In closing, I would make da**ed sure I had exhausted all treatment forms before having a fusion done. Fusions are not done to remove pain but to stabilize the spine. I think you have some homework to do. If you post where you live and asked for suggestions on good Dr.'s I'm sure people will send you a PM with helpful info. We are not allowed to post hospital/Dr.'s names on this site but here are ways around this if your interested.

  • I have only just had a lumbar fusion with cage and pedicle screws and rods, at level L4/L5.
    The surgeon also decompressed the nerve at L5 and cut a window at L3/L4 to view that level. I don't think he did anything else at that level.

    I had done a lot of research about spondylolisthesis and treatments. I had spent almost 2 years trying to avoid surgery until my surgeon (2 nd opinion) told me that my problems would get worse with time until I ended up in a wheelchair. That was the deciding factor!!

    I was prepared for the worst, after hearing some very difficult recoveries on here, but I hoped for the best. So far I have been very relieved how well I am doing, and I am glad that I went ahead and am now on the otherside of surgery. My surgery wasn't 360 anterior and posterior, just posterior access which is an easier recovery, I believe.

    I wish you well with your decision, but suggest if at all possible, that you get a second opinion.
  • Sorry to hear you may need surgery soon. But like the others suggested I would get more than 1 opinion from another Surgeon. Hopefully if you need surgery your family member could help with your wife and children and yourself. Take care and keep us posted. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Welcome to our forum.

    I would ditto the very good advice you've already been given. I saw three neurosurgeons before I had my surgery last year. So far my surgery has been successful and I've got my life back again.

    Is it possible for friends and family to help you with meals and house cleaning? There's a lot of preparation that can be done before surgery (if that's what you decide on) such as cooking meals and grocery shopping to tide you over the early recovery period. I had friends help me and also had a domestic cleaning service (once a week)for a few months.

    Keep doing your research and I'm sure you'll make a decision that's right for you.

    I hope your wife's pregnancy will become easier.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
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