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L5-S1 ALIF 10 weeks ago...continued pain, help

Brief history - successful discectomy 2/28/12 at L5-S1 for herniated disc; sciatica in right leg returned in late May. Two MRIs revealed disc degeneration. I wasn't comfortable proceeding with a PLIF with my existing surgeon, and after some research and recommendations I decided to go with an ALIF on 8/30/12 with a highly recommended surgeon. Recovery seemed to be going well with moderate but manageable pain up until about 3 weeks ago, when I began feeling sciatic pain in the right leg again that at times is close to what I was experiencing before the fusion. Not as bad, but very painful and disruptive to work and life in general. My ALIF surgeon put me on a 7-day steroid pack which did nothing to help. He then OK'd temporarily bumping me back up to oxycodone (I had been on Lortab 3x/day for the prior 4 weeks) and requested a new MRI to see if anything stood out.

MRI results revealed a small pocket of fluid back there but the images suggested it was not impacting the nerve. No other significant findings. With that, the only suggestion is the pain I'm experiencing is just part of the recovery process as the nerve grows out, which obviously can take months. I expected some continued pain in the months following the surgery, but not at the level I'm currently going through. They are also referring me to a pain management MD, because according to my surgeon's gopher they're not allowed to continue prescribing me pain medications.

A couple of things are bothering me now. I can't tell if my surgeon is trying to get rid of me (I do still have another follow-up xray appointment Dec. 10) and they feel like I'm making things up, or if this is truly part of the post-surgical recovery. I'm very concerned about the level of sciatic pain and whether or not I can expect things to get better, since technically my MRI didn't show any problems. Ten weeks out, is this common for L5-S1 ALIF patients? Neurosurgeons/orthopedic surgeons often say it can take a year or more to resolve, meanwhile other patients go a few months and they're back to a (mostly) normal life. How concerned should I be right now? Tips/suggestions?

Worried as hell in Atlanta-


  • cjp1986ccjp1986 Posts: 42
    edited 11/24/2012 - 12:26 PM
    I had 5 hr, L3-4, and L4-5 lumbar fusion with hardware on Sept 17, After surgery i could not move my Left leg. the surgery was to fix my RIGHT hip and leg pain. They say it is nerve damage and will take a while to heal, since nerves heal slowly. Good luck and God Bless.
  • the operation was hell i spent the night in recovery in too much pain .i spent the next 7 days in hospital wondering why had i agree to the operation .i spent the next 6 weeks zombied on my recliner feeling like death .i have been up and down over the last 11 months .still in pain and unable to sleep .legs and feet swelling .i am now waiting to see my consultant for my 12 months check .i feel that i have do more damage than good and my quality of life has gone down big time ,,,a typical day is .wake 2 hours after going to bed come down stairs take pain killers have a shower get back on recliner and stay there all day then go back to bed ..if i feel well enough to do anything it will wipe me out for the next week or so .its a living hell .with every operation i have had i have gotten weaker ...this is my 3rd operation ..ALIF is a massive operation and recovery is hard and long .expect problems
    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
  • diamondeddiamonde Posts: 185
    edited 11/27/2012 - 7:46 AM
    Hi Hiker

    Did they comment on your facet joint in the MRI?? For me my pain continued off and on over the years due to arthritis in the facet joints (several!!) Arthritic Facet joints can cause the sciatic pain..... so may want to inquire about it if they didn't say specifically... also... the sacroiliac joint can cause simialar symptoms.... I wouldn't worry that they might think your making it up... spine docs are well used to these kind of pains and the nerve recovery. You have to be patient... and ride through the ups and downs. Keep walking and excercising as best you can... try and eat healthy, watch weight, maintain your "core" muscles... and all that jazz they keep telling us to do!!! LOL at your pace and at your ability!. I had my lumbar fusion L4/5 in 1998; but am now having problems at L5/S1... and L3/4.... They just did another Facet Block/Rhizolysis... and I may need a rhizotomy... and if my sciatica doesn't settle from this facet block/rhizolysis... they'll start talking about extending my fuison as I have a bulging disc.... so it is ups and downs.... you will recover!! Stay positive!! it is so important to keep a positive attitude and notice every little improvement!! If we get down... dare i say depressed... we feel pain MORE.... I hope your pain eases up and that today... and tomorrow are better days!!
    L4-L5 fusion 1998; ACDF C4-6 2008; DDD
  • Is that at about 10 weeks out the pain does increase to slowly improve again at 12 weeks and keep on getting better, but slowly. For me, the increase in movement and activity seemed to contribute to the "set-back".

    Don't give up. Keep moving and doing your PT, it does get better. If it does not, or gets worse, there's another problem and you should tell your doctor. After my first surgery it turned out to be an infection.

    I am now 18 months after my redo, walk at least 3 miles 5 times a week, work a full day and pick up my grandson!
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