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L5-S1 Anterior Lumbar Interbody Fusion (ALIF) - Day 8

kmatmkkmatm Posts: 3
edited 06/11/2012 - 8:54 AM in Back Surgery and Neck Surgery
Thought I'd post an account of my surgery and experiences to date. To begin with a little history - I'm a 32 year old male living in Australia. Had a microdiscectomy 3 years ago and until the beginning of the year had not been experiencing any recurring pain. Early this year some pain returned and after another MRI, decided the disc (at L5-S1) was so far degenerated that the time was right for the next (and hopefully final) step - spine fusion.

Today is day 8 post-ALIF at L5-S1. I have a plate and 4 screws screwed into the vertebrae (looks cool on the x-ray), and a waterproof bandage across my lower abdomen to keep the wound clean and dry, so I've yet to see how large the entry was and scar will be. I'd guess at around 10-15cm.

I am experiencing surprisingly very little pain, not even bothering to take pain killers now that I'm home. In fact the first thing I asked after waking up after the surgery was whether they had finished completely, even 10 minutes after waking I experienced almost no pain. The whole hospital stay, I could not rate the pain higher than 1/10, even without pain medication. In fact once I was moved to my room, 4 hours post-op, it took me another 3-4 hours to bother hitting the meds button - I was hooked up to both a drip and pain medication containing a mix of ketamine, fentanyl, and something to counter nausea, which I did not experience. I could have got through post-op without the need for any pain medication, which was not what I was expecting at all. I was also given 200mg Tramadol on occasion in hospital. All I was given to take home were Panadeine-Forte (500mg paracetamol, 30mg codeine).

The hospital stay was 5 days. Nil-by-mouth for 24 hours, and was not allowed solid food until lunch the 3rd day. I had a catheter, during the operation a needle in my neck to provide any additional blood (an amount of my own was taken while I was under), two needles in my left wrist and back of my hand, and pre/during-surgery, electrodes on my chest and forehead to measure brain activity via an ECG.

Day three the machines and drips were removed, and I went for a short walk (two days completely in bed), roughly 50m around the ward. The physio gave me basic exercises, mostly for leg muscles. I also had inflatable devices on both my legs much like the thing used to measure heart rate that would inflate and deflate a few times a minute to keep circulation while I was stationary in bed.

Day four I was up and walking around the ward on my own, a few hundred metres at a time.

Day five I was released home. There are lots of restrictions - no driving, bending, twisting, swimming, and can only lift up to 4kg. So I spend the majority of time in bed reading, watching movies, music, and short walks along the footpath.

I have two 'grabbers', one by the bed and one in the bathroom for when I drop things. I'd also moved all food, toiletries etc onto the top shelves, and a few friends have brought over food.

So over all so far, quite an unexpectedly easy experience (as far as spine surgery can go). I'm told 6-8 weeks before I can return to work, and 8 months before full recovery. Again, pain is close to non-existent, to the point that I have to remind myself that I'm still bandaged and recovering from major surgery, and that I shouldn't go for a run.

Hope my account helps give people some info on what I've experienced.



  • Forgot to add, as well as the plate and screws I also have a cage containing BMP (bone morphogenetic protein which is built from rDNA) at L5-S1 where the disc was removed from - also visible on x-ray.
  • hi karl

    Your recovery and story is honestly amazing and im so happy for you. Im 13 weeks post op (alif l5/s1) and only just going back to work in 2 weeks on admin duties instead of my physical nursing job, but still needing regular mild painkillers being i was in chronic pain for 2 years before.

    Continue as you are, it sounds like its working!

    All the best, please keep us updated on your progress.


    L5/s1 discectomy & decompression 2009
    ALIF l5/s1 2011
    Awaiting X-ray & consultant to see if fused, but experiencing a lot of pain again :( 2013
  • i am very happy for you that you seem to be having the very best off results and recovering well /please remember that you are still a young man and young men tend to over do things !! dont or you will regret it .at your age remember there is s very good chance that at some stage in your life you will require revision surgey..
    you have given a very graphic account of your
    stay in hospital {i dont know if that's a good or bad thing ...as i need ALIF myself !!}.i have already had 2 operations on my back {see my signature .post below} and i dont know how you were before your operation ?? but for the last 16 years and the last 5 i have been in agony ..thats 16 years total .my last op was in 2007 and it was a failure due to the first op being done by some one not qualified enough to deal with my back .so now at 45 i have the spine of an 80 year old ..i guess my recovery wont be as good as yours .//i wish you the best of everything in your continued recovery but please remember you are recovering every day .the slightest wrong thing may put you back in hospital .if you are lucky enough to get away with no/hardly any pain then you have done very very well .repairing a prepared back is never as successful
    tony {uk}
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • Hi Karl,

    I am encouraged by your successful surgery and so far recovery!! Thats fantastic!!!!

    I had the same surgery as you 2 and a 1/2 weeks ago but my experience has been slightly different!!

    I was only in the hospital 3 days and on the second day they removed my pain pump and the compression things on my legs and had me up walking, by the 3rd morning I was discharged. I did have pain but not much back pain it was a lot from my abdominal incision. By day 3 they removed my dressing and I have had nothing on it since. Its about 6 inches long and was closed with surgical glue. I have a vertical incision inside that cut through my abdominal muscles which is the one mostly responsible for my pain.

    My back pain didn't start until my 2 week post op appointments. I think personally in was because I was doing more, showering, dressing, doing makeup/hair and the car rides.....it exhausted me and its been hurting ever since.

    To be honest,I had severe hip pain prior to surgery and a lot of my pain is still coming from my hip, I get a lot of leg pain but not sure if my hip or my back is responsible, only time will tell. I use the ice a lot and I am using my treadmill for walking.

    My abdominal swelling has finally gone down and the pain there is very much improved. My stamina is short, its hard to try and do a full day of activities with the family, I have to take breaks and lie down. I am still very early in my recovery too.

    I am still on my pain meds, my back aches enough to warrant it along with my hip and leg pain, I get numbness down my leg still but I am hoping that it is just all part of the recovery process and will eventually go away!!!

    I am a teacher assistant and I go back to work mid August so I have to be all well by then!! Yeah!!

    However all my stuff aside, I just wanted to compare, but you are doing simply fantastic but as others have reminded you, it was still major surgery, don't be fooled into doing something because your not in pain and over do it, your body is still healing, but I am sure you are going to do just fine.

    Take it easy, keep us posted on your progress and keep up the great work!!!

    Have a wonderful day,
  • You're having an incredible recovery - hope you continue to do as well, but then you're young!!

    I'm from Perth and had an ALIF L4-5 nearly 2 years ago and it's been a success and I can do most of what I want. Being an old girl, it took me longer to recover, but I had no problems.

    Do post again and let us know how well you're doing.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • Thanks for the replies.

    Today is three weeks post-op, and still doing well. As before, very little pain. Started physio this week, and they recommended I try pool-jogging and simple low/no impact cardio exercises at the gym. Still haven't attempted to get shoes on though, which I'll obviously need for the gym.

    Can drive short distances and made it to the supermarket for food! But anything longer than 10 mins or so in the car starts to feel uncomfortable.

    I still have a few more (3-4) weeks off work, and there are still lots of things I'm advised not to try, but overall all seems well.

    Immediately prior to surgery pain was not too severe, although in the earlier parts of the year it had got bad enough to see the surgeon again and get another MRI, and 3 years ago around the time I had the discectomy, pain was very bad. I was away running training for work and I actually collapsed in the hotel I was staying in, so I know how bad it can get.
  • Great going on your recovery. I would suggest a long handled shoe horn for getting on shoes for walking. If you are really good with the grabber you can pull out the tongue with it and use the shoe horn to get your foot in. I put elastic laces in so eliminated that part of it. And socks are over rated!! Keep up the good work.

    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.
  • Your recovery is truly amazing to hear! I go to the doctor on Tuesday and am expecting to hear that I need ALIF on 1 or 3 levels. I', only 28 so I'm pretty terrified. After reading your story, I feel a little bit better :) Please take great care of yourself! Good luck to you!
  • Let me know how the doctor app't goes on tuesday. Do you have cats?? I have 5!!

    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.
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