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Has anyone here have minimally invasive spinal fusion?

mkim680mmkim680 Posts: 19
edited 06/11/2012 - 8:47 AM in Back Surgery and Neck Surgery
I have been doing a lot of research in this area and wanted to know if anyone on this has had the fusion procedure in this method. What are the advantages and disadvantages as opposed to open fusion? I have read that it is a quicker recovery time and less muscle/tissue disection.


  • Hello. I just has a minimally invasive fusion done on Sept. 2... 2 weeks ago yesterday. Mine was L5-S1. I stayed in the hospital one night. I was allowed to stay a 2nd, but it was left up to me and I felt ready to leave. I have a sedentary office job with no twisting or bending, so my surgeon thinks I'll be back to work by around Nov. 1. I have 2 small incisions about 2 inches long each... or maybe even less.

    OK, that was the straight factual stuff... anything I say from here is just my opinion and personal experience. I have NO medical training and no way of knowing if my experience will be anything like yours would be...

    I feel like I am doing great and am really happy to find that in my case, the recover does indeed seem to be going amazingly fast. Keep in mind I am also only 38, and I've always heard that age has a big impact on recovery times. Anyway, I am walking 1/2 mile a day comfortably and a mile uncomfortably (oops- got over-zealous)... but I was a walker before the surgery, so it is habit for me even though I haven't been able to walk for 6 months pre-op due to pain. I can sit comfortably too, but I have to get up and take breaks (walks) pretty often. Since I am just 2 weeks out, I can't say much about effectiveness except that my leg pain is 100% gone and that was about 60% of my pain. So overall I am happy SO FAR that I went the minimally invasive route.

    Now, I understand that this is totally unrelated to your question, but I need to get something off my chest. Despite everything I have said, my experience was not good in all respects. I had brought up to both the surgeon and the surgeon's nurse that I was concerned about post-op pain meds because I thought I had a small opiate tolerance. I let them get away with generic answers, and I paid for it with 9 post-op days of terrible pain. The meds they gave for 6 hours of pain control wore off for me after 2.5-3 hrs. That left me at a 7-8 on the pain scale for 12-14 hours out of those days. (They never did help me even after me and my wife talked to them 4 times.) So discuss any medication concerns with your doc if you can. I wish I had pushed it more.
  • I have had one. A tlif 2 level fusion.
    There are different types of this surgery, if you could be more specific to the one you are asking about.
    There is also a link here where you can read up on them, in the back surgery segment.
    There is the tlif,plif, alif, and maybe more.
  • He only gave me a 50/50 chance i would be better though because he can't determine fully where the nerve pain is being generated from since i have nothing pinching the nerve. I appreciated that he was honest and said even if i do the surgery I can't already be in worse pain that I am in now.
  • Sounds like if it is your first surgery it may be good option. I have an minimally invasive disectomy after having an open back laminectomy two years before and it did not work. Now I am going for a fusion. I just feel more comfortable with them being able to see everything.

  • Surgery is a pretty risky proposition for only a 50/50 chance of helping. And, really, he's only guessing at those numbers, if he hasn't localized the pain source. Spine health is full of failed spine surgery patients- people who suffer the results of having hardware in their backs with nothing to show for it.

    Have you gotten a second opinion? I would be running for a second and 3rd opinion. Wouldn't it be nice if you found someone who *could* locate the pain generator give you some better odds?

    eta: My surgeon does XLIF, which looks unbearably cool, but unfortunately minimally invasive is not in my future.
  • Hi mkim680,

    I had Percudyn Implants put in on March 12th this year.I was in hospital overnight and the car ride home was agony.
    After a few days becoming accustomed to the stitches and large dressing I started to try walking regularly.Within a week I was walking a couple of miles every day(without pain).
    Although I was still on MST morphine and had to wean off it I felt great.
    Within around 3 weeks I managed to get off the it and still felt great.
    Unfortunately after being back in work for 3 weeks my pain returned but at least I had some relief.

    After x rays and another consultation it seems one of my implants has worked itself loose so now I'm on a waiting list for fusion.

    Onward and upward eh.
  • Have not had a MIS yet, but am scheduled to have a MI TLIF @ L5/S1 in November.

    Out of curiosity did your doctor say you would have to wear a brace afterwards?

  • I'm sorry, Chris. I didn't know if you were asking me or someone else. I didn't need a brace.

    Perhaps others did?
  • I have been doing major home improvements for the past 25 years and with all of my power tools, squares, tape measures, levels, etc., I still have trouble hanging a cabinet door.

    I am totally amazed that a surgeon can do a TLIF-type fusion, including extracting bone from my hip all through two tiny incisions (2 inches each) on either side of my lower back. The pedicle screws are quite large as well. If you think about the criticality of the alignment and all of the procedural steps that they have to do, it's hard to comprehend that they can do it with such small openings. My surgeon can come hang my cabinet doors any day! :)

    It's not my place to recommend that you do or do not have a fusion, but as Brenda said, if they are only giving you a 50/50 chance of improvement, I agree that you might want to consider more diagnostic evaluation. I can't recall if you had a discography (aka discogram) performed. Even those are not 100% conclusive, but they do provide important insight to your doctor. The decision is yours and yours alone. I hope you will continue to gain knowledge about your options so that you and your doctor can agree on the best approach.

    Lastly, and again this is my opinion, I really liked the fact that they did the entire procedure from my back. The thought of abdominal surgery freaked me out a bit.

    Best wishes,
  • Reformed1 said:

    It's not my place to recommend that you do or do not have a fusion, but as Brenda said, if they are only giving you a 50/50 chance of improvement, I agree that you might want to consider more diagnostic evaluation.
    Hehe...psst, that was HB's comment, not mine. It must be the similar avatars that confused ya! (G)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • My doctor seems to have the same problem as well. I think our issues all start to look and sound the same after awhile.

    Sorry about that! :)
  • Just as long as you are going into this knowing that there is no such thing as minimally invasive spinal fusion. That is a marketing technique. If you see the x-rays of these types of fusions, there is nothing minimal about it.

    They can get away with calling that since they are not cutting through your stomach, side, or hip. It is the "Least" invasive way to do it, but it is highly invasive.

    Talk to people that had it, and keep in mind that the first few months there is a false sense of hope. Usually things will start to go wrong around the 5th or 6th month.

    Make sure you do a lot of research, and not just on the site of the manufacturer. Sometimes Drs get a cut of every certain type of surgery they do from the company that makes the hardware. Not saying or implying they all do, but make sure you do your own research.
  • ccope said:
    Have not had a MIS yet, but am scheduled to have a MI TLIF @ L5/S1 in November.

    Out of curiosity did your doctor say you would have to wear a brace afterwards?


    I am 18 days out from my minimally invasive TLIF @ L5-S1, and yes, I have to wear a brace. To be honest though, I really like my brace. Don't get my wrong, I'd rather not have to wear it, but I can really tell that it is helping me to move around a TON more than I would without it.

    I think comfort depends on the brace type, because I had one in the past (from a misguided rehab doc who was grasping at straws to help me) and it was awful. This one is as comfortable as I can imagine a back brace to be.

    I have to wear it anytime I am not laying down. So for sitting, standing, walking, everything other than laying down (and showering) have I wear it. You actually get used to it pretty fast... at least I did.
  • Will I Am said:
    "there is no such thing as minimally invasive spinal fusion."

    "It is the "Least" invasive way to do it..."

    As a former English major and teacher, I am pretty sure that "minimal" and "least" are synonyms in this context (words that mean the same thing). Actually one could easily argue that the connotation of "least" is more potent because it is a superlative and "minimally" is not. They could use the word "least" instead of "minimally" and it would not change the meaning of the phrase.

    But you are correct that any back surgery is highly invasive... you'll never see a claim of a Non-Invasive Fusion. Marketing technique or not, it is just indicating that the surgery is being performed in the least/minimally invasive way the surgeon feels he can accomplish what needs to be done.

    My surgeon discussed both options with me and my wife. Explained that he does both in about equal amounts these days, and showed on my films why he believed that the least invasive (ie- minimally invasive) was probably the way to go in my case. He actually left the choice up to me because which every route I chose, he'd basically be doing the same things once he got in there.
  • Thank you for mentally flexing on me. I stand corrected, and humbled.

    I am pretty sure you knew what I meant.
  • Will I Am said:
    Thank you for mentally flexing on me. I stand corrected, and humbled.

    I am pretty sure you knew what I meant.
    I did understand. And I was not trying to be a jerk. I just didn't want people to think that the term "Minimally Invasive" was some kind of lie or scam. It's invasive alright! Just like it says it is. I definitely feel like I was invaded. But factually it was much less invasive than what else was offered.

    I do apologize for my tone as well. Your pessimism about what happens after 5-6 months scared me since I just had the surgery in question. I think I let that fear make me to be a bit more testy than I intended, and I am sorry for it.
  • It's no problem, we are all testy here. That is why we are here.

    I didn't mean to freak you out. All you can do is stay positive. A lot people I have talked to, including myself, have felt that "great" feeling around the 2-3 month mark, and then went downhill from there. Others stayed at that "great" feeling, and never looked back.

    You may be in the latter, so keep on keeping on. That is all you can do.
  • Hi mkim,

    I had a MI TLIF L5-S1 and am 14 1/2 months out and am feeling very good. I was 52 when I had the surgery. I had a good report at the year check, I'm fused, all hardware is in place, most of the neurological issues I had are gone (just some lingering numbness last 2 toes), I have virtually no pain and finally feel I'm able to go back to work and am actively searching for a job. My OSS prefers to do MI procedures when possible as he feels it makes the recovery on one of the most invasive/traumatic surgeries an individual could undergo a bit easier since the incisions are smaller and there's no muscle stripping as the 'ports' used are inserted along the natural striations/divisons of muscle. That said, please understand a lot of remodeling and modification of your spine will be done regardless of the method used and it was stressed to me that recovery could take anywhere from 1-3 years. You'll have to learn a new 'normal' and follow whatever guidelines you'll be given to maximize the potential for an easier recovery and a successful outcome. I had my surgery on a Monday, spent a bad 2 days due to horrible muscle spasming that finally got controlled w/ an RX cocktail and released to home early afternoon Wednesday. My OSS made sure I went home w/ a similar mix of RX's to control the pain/spasming (percoset, flexaril, valium, ultram & fentanyl patch 25 mcg changed every 3rd day) - the mix worked well and I was starting to taper off at about the 10 day mark and had switched over to extra strength tylenol when needed at 2 weeks out. I went home w/ a cane and was able to DC using it about 10-12 days out. I was given exercises/stretches to do daily by the hospital PT staff and did as much walking as I could. My doc dosen't like to use braces, as he wants you to build up your core to help support your back. At my 6 week check, I was given the OK to go back to the gym and given a 20 lbs weight limit. I continued w/ these limitations til my 1 year check when I was given the OK to slowly start increasing the weight and activities 'as tolerated'. Assuming all continues to go well, my next appointment will be at the 2 year mark, at that time, my surgeon will determine on whether he'll release me or continue to follow for another year. Do as much research as you can, a second or even third opinion isn't a bad idea IMO and please be sure that the docs you see are fellowship trained orthopedic spine specialist or neurologist who just treats spinal issues - this way you'll maximize the potential for a successful outcome. Hope this helps, please keep us posted.

  • kwell2012kkwell2012 Posts: 8
    edited 05/23/2013 - 1:46 PM
    i am wondering if anyone has gone to the chicago back institute in chicago illinois for a minimally invasive back fusion. i am currently suffering from L4 L5 herrinated discs and narrowing of the spine and degenerate disc disease from osteoarthritis. i am planning a back fusion to reduce the percentage that i will have to have more surgeries if i go with the smaller ones. i want to be able to get back to work sooner than later i work in a production job that requires lifting and bending and twisting. if any one has any advice i would like too hear from you.thanks!
  • 4 weeks ago I underwent a "minimally invasive" (ALIF) spinal fusion of the L-4/L-5, along with posterior pedicle screws. I had mine done in Atlanta. My surgeon told me there would be nothing minimal about it! I spent 4 days in the hospital. I am recovering really nicely and am having less pain than before surgery. I do not work outside the home, but I do have a 10 year old daughter. My restrictions are all lifted now, to comfort. I can drive, do light housekeeping, etc. We've spent every evening at the ball park this week for my daughter's softball tournament. Last night I was worn out, but I couldn't miss her big game. I think it speaks well of the procedure that at 4 weeks out I'm able to participate in my family activities. I am not able to make it past the 18-22 hour point without a Percocet (5/325). No softball tonight and am hoping for my first day without meds.
    Lumbar laminectomy L-4/L-5, 2006
    XLIF with posterior pedicle screws L-4/L-5, 4-23-2013
  • EMS GuyEEMS Guy Posts: 920
    edited 05/25/2013 - 7:09 AM
    As I recently found out from a different surgeon, minimally invasive procedures commonly produce more interior scar tissue than laying a person open. My MRI clearly shows where the 1" incisions over each screw has filled in with scar tissue (total of 8 incisions). Scar tissue and healthy tissue don't get along vey well! That's just one of the pain generators I have now.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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