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L5S1 360 fusion on Jan 12......kinda stressed, please share

Johnny New SpineJJohnny New Spine Posts: 14
edited 01/04/2015 - 11:11 PM in Surgery Buddies
Hi All,

I'm a 45 years old male who, after 10 years of dealing with back pain am taking full measures with a spinal fusion on Jan 12. They will be doing an anterior approach with a cage and PLIF with rods and screws. Wonderful heh? It's to treat a spondylolisthesis.

I did epidurals during the 10 years and it really helped, until recently when they stopped working.

Everybody talks about the pain after surgery. I've seen a bunch of videos on YouTube and it scares the crap out of me. I tell you, it wouldn't seem half as bad if they didn't have to cut me from the front. Accessing my spine from my abdomen just doesn't seem right!!!

Having an issue too with a cadaver bone in me. It's kinda weird to think about it. Although it gets my mind off of the catheter that they'll have to yank out.

Can someone who has had this surgery shed some light on the pain? or any of the host of other topics I've shared about? or if you are having a fusion soon, we can commiserate on our situations.

Thanks to all who have read this :)



  • LizLiz Posts: 7,832

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Johnny I had a 360 fusion in August of 2013 for grade 2 spondy L5-S1. I had mine on two different days the Anterior ALIF was done Monday and the PLIF was done Wednesday.

    I can honestly say that this surgery was the best thing I have ever done in my life. I would only do the 360 fusion as you are having . I know 3 other people that had spinal fusions, myself and a friend had the 360 and the two others had just a TLIF or PLIF by far the 360s have turned out much better IMO. The pain isn't what everyone portrays it or what you would think it would be. The ALIF pain was next to none and I truly mean that from the minute I woke up I couldn't believe how little pain there was. Now with that being said my doctor used a long term numbing injection right before I woke up that lasts up to 72 hours (I really wish I could remember the name of this cause it was amazing) and I had an amazing general surgeon that did the access for the ortho/neuro surgeon. The PLIF was quite a bit more painful than the front. I would say there was really only 24-36 hours of what I call real serious pain though (the pain where you really are uncomfortable) but for basically being cut into two, having a plate, 8 screws, rods and a cage installed it wasn't that bad. As far as the cadaver bone I had that as well and had a full solid fusion after a year. I really believe that using your own from the hip it adds a lot of unnecessary pain long term. My doctor mixed the cadaver bone and the bone that he removed from me. I knew from the minute I woke up from the first surgery that the surgery was a success as my leg didn't feel like I wanted to saw it off anymore and I could actually start feeling a bit in it aswell. The 5 days I spent in the hospital I seen and felt improvement everyday.

    You will get out of the surgery what you commit to put into the surgery!! I cannot stress that enough. Walk, walk, walk and walk some more your body will tell you if enough is enough. It was tough and a lot of work but I kept pushing my limits and I was walking 3-4 miles a day 1.5-2 weeks after surgery. I was back to work 6 weeks after surgery .

    I won't keep rambling on but I will be happy to answer any questions you have if you would like to PM me on any questions you might have. I was very worried just as you are but trust me knowing what I know now, I would do it tomorrow in a New York minute. With fusions you only hear 1 good story for every 100 bad ones! But trust me there are plenty of success story's out there! Good luck please feel free to reach out if you would like to! Robert
    L5-S1 anterior/posterior 360 fusion Aug 2013
    Grade 2 spondy, Severe DDD L5-S1
    L4 Facet arthritis
  • I would never have this surgery again. Too painful and it did not work.
  • I'm a 54 yr. old Female who loves to snow ski, I'm very active and in good shape,
    I too had a 360 fusion 12-20-14
    The surgery was a success, I wish I had done it sooner 5 years of pain and I have my life back!
    I'm feeling much better now, I don't scare easily, but this created anxiety and fear like Ive never experienced
    before. I had a good Doctor who was calm and reassuring and that helped. the surgery took 5 hours and I stayed in the hospital 4 days, I'm on Percocet now, but pains not that bad, I walk every day and have a therapist twice a week.
    I wear a back brace and bone stimulator post op. The scars are small and I'm healing nicely.
    I know it seems scary but its not as bad as it sounds.
    Tracey Hill
  • I am in a very similar position to you - 36, spondy, facing an ALIF, with posterior fixation at the end of February. Good luck to you. I look forward to hearing your success story in a few days/ weeks.
  • Glad you posted Johnny. I'm scheduled for 360 fusion on 1/30. For grade 2 Spondylolethesis. They will replace L3/L4 & L4/L5 discs anteriorly then rods and screws from L4-S1post. I have a failed fusion from 1989 w/o instrumentation. Having been thru it once already albeit smaller, I know what to expect. This could be tougher because I have a lot of scar tissue and have had two major abdominal surgeries. Who knows what they'll find when they go in. It's true, there are a lot of people here who have had bad outcomes , but also many success stories. I need to hold on to those that will give me hope. It is a long haul and I remember it taking about 18 months before I really felt like I was fully functional again. That's pretty average. We start feeling stronger and better but it takes time. A marathon not a sprint. I've been getting my house prepared for the long winter in the house. I have a treadmill, recumbent bike, massage table, plus more in a work room. I'm very lucky. Yours is coming soon, please try and keep us posted on the results and your progress. Good luck Johnny.
  • Thank you Robert, littleone, Tracey, Paula,.......and even you scolby (I'm sorry it didn't work) for your replies and words of encouragement.
    Ok more info on me....I use to be a Physical Therapist!!! what REALLY freaks me out, is that I saw SOOO many people that had a lumbar fusion and it didn't work!! Not only didn't it work, but made the pain worse ( I hear you scolby) I've been to 5 doctors they all say the same thing, I need the fusion. However, I'm battling a LOT of past patients in my head.
    But I know, honestly, that people do not have the best doctors, that they have secondary gains for continuing to be sick, and a lot of other factors that keep people in pain.
    I saw the doctor today and I feel better, he is using the synthetic bone for the grafting and said that the procedure would be about 2.5 hours.
    Ignorance is truly bliss, I know too much, but seeing your posts here, hearing the success stories and knowing that you have gone though (and will go through this) makes it better.
    So in-between pushing that PCA every 5 seconds I will try to update you!!! The surgery is Monday. Please say a prayer or think a good thought for this PT who SWORE he would never have a lumbar fusion, now having one in less than 4 days!!!!!
    Eeeekkkkk......I mean Yea!!!!!!!!! positive thinking :)
  • littleone said:
    I am in a very similar position to you - 36, spondy, facing an ALIF, with posterior fixation at the end of February. Good luck to you. I look forward to hearing your success story in a few days/ weeks.
    I will for sure update you on the good, the bad, and the hopefully pretty outcome of the surgery. I just found out today that they are using synthetic bone for the graft. At least I don't have to worry about the bone guy's spirit living in me :)

    Take care, and it you have any questions, feel free to ask. What really confused me is exactly what kind of fusion they were doing. I'm having ALIF and Post approach with screws and rods in the same surgery.

    Good luck to you and I'll add to my post again!!!
  • Hi Everyone,

    I am now 4 days post op. Surgery was on a Monday, today is Friday. I came home yesterday. I want to talk about my experiences and see if I can help someone else who will be having this, as I relied a lot on people's feedback to gauge my own recovery.

    When I woke up in recovery, surprisingly, I didn't have as much pain as I thought. I was more out of it from the anesthesia and uncomfortable. The doctor said that they were going to give me a TAP block which probably helped. When I got wheeled into my room, the pain level did rise. But I hit the PCA as often as I could. But then I started getting nauseous. They gave me Zofran, and after about an hour, it still didn't work. It was during this time when I wasn't hitting the pump that the pain was increasing. When the Zofran didn't work, the nurse was sort of at a loss of what to do. Great. And since I wasn't hitting the PCA button that the pain spiked up.

    I use to sell Pharmaceuticals so I know my meds. I suggested to the nurse they give me Promethazine. She shrugged her shoulder and gave me only 10mg. It worked like a charm!!!! I think the nausea was because of the narcotics, and to me, the Promethazine has worked better for that in the past.

    Once I got the nausea under control I was hitting the button every 8 minutes, and faired ok. I think there's an unrealistic expectation about the pain. Even with as much stuff as they give you, about an 80% pain control is about what you're going to get. The pain was actually more uncomfortable and a restless feeling. It wasn't like the pain I had prior to surgery. It's hard to describe. You're just feel really uneasy. When they get you up and change positions, that's when I felt the sharp pain at the incision site in the back. Now that hurts. The front had little to no pain.

    My wife stayed with me for 2 nights in the hospital (she didn't get much sleep) and my parents during most of the day. If I could change a few things I would have someone (even if I had to pay them) stay with me 24/7 the first 2 days. You can't move, you can't get up and it gets old pressing the call button every time you can't reach for something or want more water, or for whatever. This also adds to the stress and the pain level. It would have been money well spent.
    I would also not have any visitors. So many people wanted to come and told me prior to surgery they would visit, and since I've always liked to have lots of people around me, I told them yes and encouraged them to come. Its too much. Even though they tell you to relax, it's hard to do when 7 people are in the room looking at you. A good buddy visited me, and kept telling me how I looked well and good. When you just had major surgery and feel like crap that's about the last thing you want to hear is how well you look. Bottom line, don't have too many visitors.
    They took the catheter out 30 hours after surgery. I was stressing like a mad dog over this one. However, it wasn't too bad!! After they deflate the balloon, in the bladder, they inject some saline, so it sort of slips out with one tugg. I think it's bad when they leave it in over 48 hours or longer that it burns a great deal. It wasn't worth the stress. Rest assured of all the things to worry about, don't stress over the catheter.
    However, they do want you to pee within 8 hours after the catheter removal, or they would have to put it back in!!! Didn't know about this. I drank a ton of water to no avail. Talk about pressure!! and the clock was ticking. It wasn't until I added essential lemon, wild orange and lime oil to the water that I finally went.

    I spent 3 nights in the hospital. I made sure they discharged me with a front wheeled walker, and a raised toilet seat, which also can be used for sitting during a shower.

    I have a hospital bed in my living room since our bedroom is upstairs and they want you to talk a TON but avoid stairs. I just rented it on my own $400 but well worth it.

    So that's the story so far, I've been walking around as much as I can taking only 1 Percocet (they said up to 2) every 4 hours and 1 Soma 2 times a day. I think tomorrow I will progress to a cane as the walker is now more of a hindrance. I'll write more tonight when I get a chance as I'm sure I left some things out that fusion people might find interesting.

    Thank you everyone for your support, and if i can help notify me. Good luck to everyone having surgery soon.
  • I hope the recovery is getting easier for you. It must be nice to be home.
    Becoming completely dependent on others to meet all of your needs must be amazingly difficult!
    How is your pain now?
  • Hi Littleone,

    I am 11 days post op. My pain is very low. I'm down to 2 10mg Percocet a day and would like to be completely off of them by next week. I think part of the reason is that I was taking no pain pills prior to my surgery. I had a issue with them a few years back and didn't want to risk taking any. What really convinced me not to take any is that the doctor told me the less pills you take, the better we will be able to control your pain after. Trust me it WAS TOUGH. But I knew it would be for the greater good after the surgery if I didn't take them.
    Some people are eating so many pain pills that they can't give them enough after surgery to control the pain. I feel for those people. But if there is any advice I could give would be to reduce amount before surgery, that way what they do give you will work.
    My leg pain is gone, but I still continue to have numbness at the bottom of the foot. I have "tightness" in the back. It feels very weird. It could be from the staples, which I get removed next week. All in all I know I'm on the right track and as I've said in another post, I would have this surgery again (ant/post 360 Lumbar fusion) again without thinking twice.
    Which I might have to someday as most of us know that once they fuse one level the levels below and above may start becoming unstable in the future.
  • Wow! Your story has quite a few simularities to my situation last year. The catheter , pain button etc. , all good times! LOL.
    The first 6 weeks seem to be , at least for me , the worst of the storm. At about week 7 , things really took a dramatic positive direction. I was back to work and the gym at week 10. Albeit a light workout , treadmill and elliptical but at least it was a start! Things will improve by following your physicians directions and by having patience. For myself , walking was key to rehabilitation.
    As for now , at about 6 months post op , all is good as I feel pretty normal. My physician did indicate that at this juncture , one can experience a set back due to feeling too good. That said , I'm still being carefull as I don't want to relapse.
    About me: 52 yo HWP active male.
    Hope this helps?
    Best of luck with your recovery!
    Bilateral L5 spondylolysis L5 with grade I anterolisthesis L5-S1.
    Stable multilevel degenerative spondylosis contributing to mild canal
    narrowing L2-3 and L3-4.
    360 ALIF & PLIF L-4 - S-1 on 8/11/14
  • Johnny New SpineJJohnny New Spine Posts: 14
    edited 01/29/2015 - 6:32 PM
    Hi All,

    It's been 2 weeks, 3 days since the fusion. Quick update.

    I'm doing well. I went to the doctor 2 days ago. He took an x-ray and said everything was looking good. He actually said I should be the poster child for back fusion since I am doing so good. He took the staples out which was the last thing I was sort of worried about. Some people have said how painful it is. It did pinch a little, but just talking to him during the procedure took my mind off of the pinching so it wasn't that bad. Those "some people" they can't take any pain. I shouldn't take them to heart.
    By poster child, they are taking in what I tell them. I have a good attitude, say I'm feeling great, and not asking for multiple refills (none actually) of pain meds. I do have a little gut, but not grossly overweight, and this is not work-comp or a lien. So yes, I'm the ideal patient.
    I did end up having a fracture (spondylolysis) which didn't clearly show up on the CT or MRI with bone fragments pressing against the nerve. I don't know if I put it on here, after the surgery, the doctor told my wife that he didn't know how I was getting around (with no pain meds no less)
    I'm still having numbness at the bottom of my foot, and because the leg pain is gone, it's maybe more noticeable. The doctor said give it about 6 months.
    I'm getting a little cabin fever, and sort of tired telling everyone how great I feel. When it comes down to it, no one wants to hear how much pain you're in or your aches. Even though I do feel good for what I had, it wears you down being positive when people ask.
    I think I'm just finally taking in what I had done. I look at that scar in my stomach and still shutter to think what they had to do to my insides to get to my spine. It's so weird to think about it.
    WA WA WA Poor me. People in 3rd world countries can't afford this surgery and end up in wheelchairs or begging in the street walking on their hands, and I'm complaining about seeing a scar and being bored at home. Puts things into perspective.
    I hope my gibber gabber helps someone. If you are thinking about a fusion, be sure you have explored many options before doing this. I hate it when people say ALL options. How can anyone explore ALL options??? A witch doctor in Africa is an option, should I have done that too??? Its all REASONABLE options. When I went to a respectable acupuncturist and even HE told me to have the surgery I knew I had to have it. When PT, epidurals, decompression, prayers, essential oils and denial wasn't working I knew I had done everything reasonable in my power to put this surgery off. I'm glad I had the surgery and would do it again (which I might have to, since a fusion makes the segment above and below unstable).........but I'll worry about that later.
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