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ALIF operation

Hi everyone,

I am 22 and have previous had the posterior lumbar fusion but this was unsuccessful so have been put on the waiting list for the ALIF operation and wondered if anyone could help me with what to expect. I was wondering how long the operation is, what happens, what the recovery time is? Any advice on the matter and tips to help me through would be grately appreciated.

Kind Regards,

Nathan Holdbrook


  • backache99backache99 Posts: 1,338
    edited 08/16/2012 - 11:53 AM
    i can give you MY EXPERIENCE YOU MAY BE DIFFERENT .on the 29 dec 2011 i had ALIF at L4/L5 and S1 .{i have in the past had a laminectomy and on another occasion a discectomy of same disc] anyway the operation is a massive one and expect to be in pain post op make sure the staff know and they can adjust you IV accordingly .i was in recovery all night with my own anesthetist and theater technician as i was too ill to return to the spinal unit and there was not a bed in HDU ,i had a horrible night and needed massive amounts of IV pain killers .i was unable to turn and i hate laying on my back i was catheterised {this was a first for me ] and i did not like it ... my insides were very painful....moving in any direction was hell and i was very upset .i spent 6 nights in hospital then i was discharged back home .i have a recliner {rise and recliner and this was very handy as it stand you up.and i could sleep on it .{it would be a very good idea if you could purchase one {you wont regret it } it will always be there for you as i use mine every day and i am still spending half the night in mine .back to the ALIF .for the fist 6 weeks i was unable to do anything on my own even showering was done under supervision of my wife .i was so tired even shaving was an effort .after a shower i tended to cry as i felt so defeated !! it was a long time between operations five years since the last operation has failed so i had been in awful pain for a long time and i think if i would have been operated on by my consultant u have now at my second operation i feel that i would have had a better outcome .my current consultant is is probably the uk's best and when he operated on me he told me that he had very little to work with ...that's why so many consultants refused to operate on me .my wife {also a fully trained nurse} was on hand to dry me off and generally look after me and for that i can't thank here enough..after 6 weeks it was my first time back at hospital for my check up .there was nothing to see on X ray but the consultant was happy with me..its been hard work and i am still in pain and not sleeping and its been 8 months .but i have just been for my 6 months follow up and again the consultant is happy with me even though i have a lot of pain and now my legs and feet are swelling ..recovery from this operation is long around 3 years FOR ME . i needed it because my lower spine had collapsed .life is still hard and i am still not able to do much .its a hard slog with a long recovery so i wish you the best .good luck
    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
  • I've had (2) 360 operations in the last 3 years. That is where they put a cage in from the front and rods and screws in from the back.

    Tony is correct that the operation is big and depending on what your surgeon is going to do, or run across, while in the surgical fields the time can vary widely. My first on was 7 hours for a revision and the second one was 10 hours. The first week is tough at least it was for me on both operations. You have youth on your side so you may very well fair better as I'm a good bit older then you. It is as important to check out the surgeon that is going to open and close the front as it is to get a good back surgeon. There is a lot of stuff that has to be moved ouit of the way to reach the spine from the front so you want someone that has done the operation a lot.

    I agree with tony that you will need help after you get home and I wouldn't believe any surgeon that tells you you will be back up and running in a few weeks. My first 350 took me 6 months to start feeling somewhat better and a year to really feel good. It takes a long time, at least it did for me. I'm still in early recovery from the second 360 and I've made my mind up that I will never have another as it was that rough.

    Your a young one to be needing that kind of work. I hope you do your fetting out of the surgeons that will be on your team as they will play a big part in whether or not your surgery is a success.

    Good luck.
  • Hi:- I also had this procedure after a failed PLIF. It was done in two stages, a week apart. First surgery from the front to remove old cages and insert new ones took about 3 hours.I had to stay flat on my back for the week after and pain was very well controlled with pain pump for first two days and then oral medication. I also had to get IV antibiotics for an infection (the cause of the PLIF failure.)

    After a week the posterior hardware was replaced. This took 9 hours because there was a lot of scarring around the nerve and intraspinal cysts at L4 that had to be removed too. Pain a little rougher after this one, IV pump again for first 3 days, then oral meds.

    Allowed to walk (with hard brace) on third day and could manage two flights of stairs on 4th day. Could go home on day 5.

    Was able to wean off Oxycontin at 2 weeks and wore hard brace 24/7 for 12 weeks. Back to fulltime work at 12 weeks.

    I am now just over a year out, still recovering, full PT now and have regained flexibility.

    Being younger, I'm pretty sure you'll recover just marvellously and quickly! Good luck!
  • Thank you so much for all of the advice and support. it is interesting from my view point to hear other peoples experiences. Thank you to all of you again. been told the operation will be very soon due to my worsening condition at present.

    kind regards

    nathan holdbrook
    Nathan Holdbrook
  • I'm due to have ALIF in October so I'm in the same position.
    One thing I have learned about these boards is that people who have successful surgery tend to move on with their lives, so there are many stories of difficult surgeries on message boards. For every failed or difficult surgery there are many others that go well that you will never hear about.

    I'm just beginning to gather some info on my ALIF and will post back soon.
    53yrs LBP/sciatica for 18yrs - severely dibilitating.
    L5/S1 bilateral decompression, unhelpful.
    L5/S1 micro-d unhelpful.
    Upcomming L5/S1 ALIF
  • i will answer any question if it can.. and give any advice that i have found useful during my recovery .should you wish you contact me .if not remember this is a big operation and even if you feel well post op don't do anything stupid or you will end up back on the operating table for a redo ! .take time to recover and rest .i found swimming very relaxing and low impact .walking for me is hell ! .once again good luck
    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
  • Nathan, I had the lami/discetomy last October and on this next Tuesday I will have an ALIF L4-S1. So I will also report back to you my adventure with this surgery.

    Like above I've read a mixture of both and think depending on if a cage/bone (traditional fusion) or with the plastic piece with titanium screws or rods, (shame on me for not knowing the proper name as its going in my body) each group or persons had ups and downs. Ive heard from my doc that I could be back at work in 4 weeks if all is text book. I do count on what is not avoidable and the stomach recovery being the worst of it. On the flip side this approach avoids many obstacles including most important, your nerves! So hopefully you and I will fall in the middle of these outcomes. Best of luck and if you like, I'll PM you about my results.
    Weight room accident at 18. Had compression fracture and was paralyzed for month until ruptured spinal column healed. At 37 did all the epidurals/blocks. At 38 had two level open lami and Discectomy. At 39 (Sept 2012) had two level ALIF L4-S1 fusion.
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