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Is an ALIF with a Posterior Fusion the best plan of action?

My husband, who just turned 40, has been stressing over a Neurosurgeon's diagnosis and recommendation for an ALIF and a possible Posterior Lumbar Fusion.

His MRI revealed he has a bulging disc between L5 and SC1. There's protrusion into the nerve root causing numbness in his leg (no pain).

In addition, the neurosurgeon believes there is a tear in disc between L5 & L4.

He wants to do a discogram to pinpoint the problematic areas.

Here's the issue:

He's in excellent physical condition and until a week ago was physically active mountain biking. This appointment has really messed with his head. He feel like his body is sticking tomb bomb and the disc is going to burst at any moment. The idea of an extreme surgery and the rehabilitation time after is also overwhelming. He has numbness in his leg but no pain. His back has minimal pain.

Anyone else in this scenario?

Is it possible he'll be in worse shape after the surgery?

If you have personal experience with this or had success with surgery or a different treatment please share it with me.

Thank you so very much!



  • backache99backache99 Posts: 1,338
    edited 02/11/2013 - 7:21 PM
    the consultant will do the ALIF [anterior inter body fusion} through his abdomen and if he is happy that he has a secure fix he wont flip your husband over and do a PLIF .i was scheduled for the ALIF/PLIF too also known as a 360 but after my consultant had done the ALIF he ad no need to do the PLIF part of the operation .your consultant wont know this until he has opened him up .if you say your husband is in good shape and this is his first operation on his spine he should recover within 6 months .i had a ALIF 13 months ago and today 12/2/13 o go for a CT scan as i am still getting loads of pain in my back and both legs .i had had previous operations on my spine and have been in long term pain for 16 years ,good luck with his operation .despite his fitness he will need plenty of help for at least 6 weeks post surgery .any spinal surgery is major so even if he feels well make sure he doesn't over do things or he will find myself back in theater
    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
  • catfishmanccatfishman Posts: 185
    edited 02/12/2013 - 4:16 AM
    daizylublue, has your husband tried anything else, such as physical thereapy, or anything? i only ask because i have a herniated l5,s1 and bulging l4,l5 and this was diagnosed 2 years ago. they recomended a microdiscectomy for me, and my leg pain is a leg pain, not numbing. but for me surgery is a last option. i do take celebrex, gabapentin, and nucynta er, but still have pain. good luck to whatever he decides.
  • He doesn't have leg pain and minimal back pain. I guess that's why we are questioning such a drastic measure. He has not done physical therapy for an extended amount of time. I guess the doctor told him the problem is his nerve root is effected and over time the damage can worsen and even be permanent. Still, if he's in no pain we are thinking the complications that can result from an ALIF are far worse than what he's experiencing now.

    He is physically active, stretches, yoga and mountain biking. That's his passion but he is now terrified to do so thinking his disc will burst. We are so lost right now. I told him we need to go back to the neurosurgeon and ask what alternatives there are.
    Also, get a second opinion from another neurosurgeon.

    He did go to an Orthopedic surgeon who recommended a disctectomy. The neurosurgeon disagreed with that plan of action and thought it would compromise the area more.

    We wonder about technology and what it will be five years from now. A fusion with a cage is permanent. There's no going back and that's weighing on him.

    Thank you both for sharing your experience.
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