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Recovery from ALIF questions

hotcoffee29hhotcoffee29 Posts: 327
edited 06/11/2012 - 8:54 AM in Back Surgery and Neck Surgery

I had my 2 week post-op with my surgeon for my ALIF at L5-S1, and everything so far is looking great! Got to see the x-rays and there it is all screwed in neatly this anterior pyramid plate, it's very small....3 little screws and I saw the 2 rods of cadaver bone that will fuse and it all looks amazing.

My questions are really out of curiosity about how you all have recovered from fusions? The reasons I ask is because up until a few days ago my back has really not been that painful, however I had some appointments which meant showers, doing my hair, car rides, walking etc and that did it....my back has hurt, my legs have spasms, it's just all increased....back and hips and legs! On top of dealing with the incisional, surgical pain in my abdomen......I understand it's just all part of the healing process after all it was only 2 weeks ago today!

However......what has shocked/surprised me the most is my Doctor.....he told me that I basically have no restrictions! Just listen to my body, if it hurts, stop! He said nothing I do can hurt this fusion, it's not going anywhere. He said this is the advantage of the anterior approach, this latest hardware is that you can't mess it up. He sees no reasons it won't fuse, only a major impact could damage it or move it, so daily activities are perfectly safe. The BLT restrictions are more about protecting my level above fusion and they will just aggravate my back and induce pain.

So I walked out of there being told that as time goes by and I fuse my pain should gradually diminish and he will see me in 6 weeks!

Is it really this easy? I know I should just feel blessed and lucky and I do, really I do, but I am still so worried I'll move the wrong way and hurt myself, but my dr assures me nothing I do can hurt my fusion!!

I just want to do this right, heal properly.....and I just never got any warnings or precautions from my dr, he told me just do whatever I feel comfortable doing.....but just the dr visit yesterday wore me out and I was in pain so I know I am not ready to just get on with it.....I still need more time!

So, what do you all think? Have others had this same advice after fusion?
Can recovery really be this easy?

Curious and confused and still hurting!

Sandra :-)


  • hi, and sorry but i cant comment about an ALIF.
    Just wishing you the best of luck.

    But i will be reading this daily cause i also need an ALIF. I already went thru a TLIF, but the ALIF sounds like it's tougher to recover from.

    good luck and take care.
  • Thank you for your well wishes.

    I am sorry you may have to endure another fusion but according to my surgeon, anterior approach is easier to recover from!

    I know that each surgeon has their own preferences and opinions but after my 2 laminectomies, I did some homework and sought out this new surgeon who took extra time with me to explain everything going on with my back and because I was just dealing with the one level he explained why this fusion can be so successful.

    I was told that going through the abdomen is better for recovery because the are not going through the back muscles. Although my stomach hurt it was nice not lying on my incision because my back hasn't been touched. This new pyramid plate is very small and will never need to be removed and the screws are tiny in comparison to the old pedicle screws so that helps decrease complications and pain from hardware.

    Like I mentioned I just had my 2 week post op appointment and he told me there isn't really much I cant do, just no impact sports or activities!

    I just wonder how others view recoveries from anterior v's posterior approach in the sense of which is easier?.. I do believe the amount of levels you are dealing with makes the biggest difference, more levels would need the posterior method.

    Hope things get better for you Jim and whatever happens in the future I wish you the best possible outcome, keep me posted!

  • My first surgery was an ALIF for L5-S1 in 2006. Recovery wasnt bad, but I didnt go back to work until almost 6 weeks later (I'm a school bus driver). Keep an eye on it though, I ended up going back 9 months later because there was still movement in the area, so he stabilized it going in through posterior with screw and rods. NOT to say that would happen to you--I have had and still have spine issues, so in your case it may be different.

    Having said that, I would take it easy and do not twist! That usually hurts.....

    EDIT---mine was a full anterior fusion through the anterior, not what you had--but still be careful....lol
  • Yes I agree! I feel it's more important to watch what I do and how I move just to ensure that I do fuse and don't cause myself more issues in the future.

    I don't think my family could handle it if I had to have another surgery, we are hoping this is it for a while. I am a teacher assistant, so like you I have my summers and that's why I do it then so I can get the recovery time. This is my 3rd back surgery, 3 summers in a row!!

    I hope things get better for you and you are enjoying your summer. I ride the bus with our students every day so I know what it's like!

    Take care,
  • Hi; and keeping an eye on your thread.
    My NS told me pretty much the same as yours told you.
    He said that with the surgery i had (tlif) there is a 90% fusion rate, and with the (alif) there is a 98% fusion rate.
    And there is actually less risk cause he dont need to avoid the nerves. And going in the front with the plate they can put more of the BMP/with cages.

    So best of luck and take care and relax, so you can heal.
  • I have had 3 fusions, one 360, one anterior and one posterior. I have a lot of hardware in my back (2 cages, one plate and a big bolt). I was told not to lift anything or do housework, etc for at least 3 weeks after each one. I could walk and after 3 weeks I could swim. I found that when I overdid I was back in pain. Its hard sometimes when you do feel good not to overdue. Err on the side of doing less instead of doing more. Its a long recovery.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • Hi Sandra,

    I had the same ALIF procedure on 5-2-2011 and my neuro told me the opposite: don't go back to work for 6-8 wks, wear my hard brace for the first 2 weeks, had me on a wheeled walker for 2 weeks and now a soft brace and a TENS unit. My surgery was to redo a previous L5/S1 fusion in 12/05. I'm still seeing my pain mgmt doc because I still hurt like I did before surgery. Maybe the advice is case by case? I saw my nuero post op at 2 and 6 weeks. Just started PT last week in a very warm pool doing very light exercises. I'm not in the medical field but I find your surgeon's advice and comments strange. I hope for the best for you.
  • BTW, my NS also put stem cells in my cage and I have to wear a stimulator 4 hours each day to stimulate their growth. My NS came highly recommended from the pain mgmt clinic I use and he is an MD, Phd. It took quite a while to get in to see him and he operates 3 days a week - I believe the spelling is Andrew Cannestra at Baptist Hosp in JAX, FL - just trying to provide more perspective for you to compare the advice. Again, maybe everyone is different so the advice may be too. Best of luck and take it slow. Jerome
  • Keep in mind most, if not all surgeons have not had this procedure done on themselves, so it's a little difficult for them to know what recovery is REALLY like. Books and studies can tell them, but until YOU are the one feeling the condition, it's hard to tell someone accurately what to expect. It's like men trying to tell women what to expect pain wise in giving birth.

    The best advice I think your doctor gave you was to listen to your body. If it hurts, stop! Though he may have said no restrictions, I would avoid let's say...waterskiing, wrestling, kickboxing, etc. I know that sounds ridiculous because at this point, you would never try that anyway. BUT, when a doctor says no restrictions there are some folks who will take that literally.

    I felt great after surgery for three months (minus normal recovery pain) but then took a nose dive while going through work "conditioning" to get me ready to go back to work. I am convinced that something happened during that time that MRI's can't see. Bottom line, don't over do anything and don't rush your recovery. Only you know what your body is capable of achieving without pain.

    Good luck,

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Actually the only restriction I got was no impact sports or activities and not just now but for ever in order to protect the upper level from fusion.

    I agree it's hard for a dr to say exactly what each persons recovery will be like. I think my Dr's main message was that my daily activities won't hurt the fusion but they will hurt me as in increase my post op pain!!

    That's exactly what is happening, the more I attempt, the more it hurts. I work for the school so I have until mid August to be the best I can be!!

    I have attempted laundry today....ouch!! But I am feeling guilty having my family do so much and instead of feeling like I am recovering from surgery, I just feel lazy!! It's hard, I find it hard to be a patient patient!!

    I do have low back pain and the same sciatic pain and numbness in my leg and foot that I had before the surgery, I am praying it does improve over time. I have abdominal swelling due to the anterior approach and he cut through my abdominal muscles so that's still healing too, my vascular surgeon told me that will take 8 weeks for a full recovery.

    I have a new pain since surgery, pain in my upper back by my shoulder blade, I think maybe from positioning during surgery, but it's a constant nagging pain every day. I have been put on Nucynta for pain now, I don't find it as effective but that was my only choice as he didn't want to keep me on the post op percocet and ocycontin, I got enough for 10 days, so I find myself waking up during the night for pain meds, I have a lot of hip pain, it hurts to lie on my bad side.....I just don't know how to go about my every day daily activities because I am still so uncomfortable, but I pray it gets easier as each day goes by.

    I am sorry about your increased pain, I don't believe we can ever be truly normal again after spine surgeon. What can you do about your new pain? Have you had a second opinion? I sure understand, and you are absolutely correct, despite what any Dr says, we all know that we have to be careful with everything we do with our backs because we end up being the ones to suffer, it just doesn't seem to take much to make it hurt a whole lot!!

    Take care and thank you and I wish you continued recovery and hopefully a day with less pain.


  • Hi Sandra! Great to speak to you again, but sorry that you needed to come back. :H

    I had a PLIF with decompression.
    My surgeon doesn't use braces at all, and at 2 weeks said I could get back to my life with no restrictions! He even said I could drive at 10 days. Well, I couldn't! There was no way that I felt ready for that as any sort of twisting was VERY painful.

    At 6 weeks, he said I could get back to my life and do anything, including sports!!! I asked if it was ok to lift my gradndaughter, do gardening and vacuuming. His answer to that was, perhaps I should wait until 3 months! At the time I thought, what a good thing that I had asked, or I would have done what he said, and done anything!

    Before my surgery, I had read lots of people on here who were saying that they felt overdoing it had caused problems, some of which had needed further surgery. I took heed of what they said, and decided to be careful and not risk causing problems, so I was more cautious than my surgeon ordered.

    My recovery has gone very well, but I am now having problems in other levels of my spine. I think that I would have been having these problems regardless of how careful I had been. I just think that I have a rubbish spine!! However, the good news is, my dentist tells me I have great teeth! :D

    Take good care of yourself Sandra. You are worth it! >:D< >:D< >:D<

  • You are all amazing and compassionate because we have all suffered through back and neck pain and surgical interventions and we know the recovery process is not easy!

    I thank you all for reminding me to slow down and take it easy, I wish my husband and family members could see it from your perspective and understand why I just don't have the stamina to do certain activities.

    Gone are the days when I never gave my back a second thought but now it's all I think about!! Thank you all for kind, gentle reminders of where I am, and what I need to do so that I can be a heathier person in the future to do family activities. The reason behind so many surgeries is so that I can get some of my life back, but I am not even 3 weeks out yet so the smart side of me tells me to take it easy, because when I get back to work, Its all go go go.....

    I am sorry to hear Jelly that you have new spinal issues going on, it just never seems to end. I do hope for you that the Dr's can find away to ease your pain without having to be too invasive, are you on summer break yet?

    I hope you all enjoy your 4th July holiday.
    Stay safe,

  • I've been going through facet joint injections, TENS and narcotics.

    The PM wants to do a RFA which scares the crap out of me. I've read too many negative outcomes on this site and others about RFA.

    The PM is pretty sure that I've developed spondy at L3 (just above the L4/S1 site) and also have DDD at L3. That's most likely caused from the fusion.

    I have an appointment again with the PM in a week, so I'll see what direction we'll go in next.

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

  • 3 weeks and counting! 8>

  • Hi Sandra

    After my surgery, I had constant pain in the upper back which hadn't been there before. With your spine now being in a different and stable position, it could be causing your muscles to spasm.

    What helped me with these muscle spasms was deep breathing exercises and lifting my arms overhead at the same time (no twisting). However, I didn't start these until 6 months out (didn't know about them before that). If you decided you might like to give them a try, then you would have to clear it with your doctor as it's early days.

    In the meantime, walk as much as you're able to in small amounts and very gently stretch the mid area of your back, which you can do sitting in a chair or on the bed. Don't be tempted to sit for too long in a normal chair. In the early days, I wasn't as gentle as perhaps I should have been, and my fusion was fine, but I've now got a hernia in my tummy - I felt it go pop when I was doing a stretch.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • Hi Trish,

    Thank you for your thoughts and tips. My spine was stretched during surgery so that makes sense to me about my muscles. The Dr told me that they stretch the spine to give back the height at the disk level that I lost with the DDD, so I am sure thats why it hurts all over!!

    I haven't been given any PT or excercises yet, just walking. I over did it this holiday weekend, trying to keep up with the family, and help out with dishes etc and today I really feel the effects of my actions all weekend. I sat a lot last night, the drive to the fireworks, the show itself, the drive home.....but today resting I spend most of my time in my bed, I have a bed that has a remote control, so I can sit up and I can put it in different comfortable positions, I find it better here than trying to sit in the living room.

    I am sorry to hear about your hernia, is that a result from ALIF? That a bit scary, will you need to have another surgery? I hope all goes well, keep me posted.

    Keith, good luck back at your PM dr, I really hope they find something that will help. I wish there was more permanent solutions for our back pain, but we do what we can and we hope that t makes things better.

    My thoughts and blessings are with all of you out there who are on the same path, we get through this together,

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