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L5-S1 fusion, one surgeon said TLIF, second opinion doc said ALIF? Confused!?!?

Gemini007GGemini007 Posts: 1
edited 03/21/2015 - 9:25 PM in Back Surgery and Neck Surgery
Hi. I am in my final days of deciding which surgeon to go with. I am 40 and have had 3 discectomies on L5-S1 (original herniation from an auto accident in 2010). Unfortunately my only option left is a fusion. The doc who did the last surgery recommends a TLIF fusion with pedical screws and rods. My second opinion surgeon (works at a highly regarded hospital in Chicago) recommends (due to a smaller, not a lot of body fat frame) an ALIF with interfusion screws no plate and a posterior discectomy to relieve the sciatica problem. He says that he wants to avoid the posterior pedicle screws due to possible future rubbing of the hardware in the back and causing pain from that since I do not have a lot of excess tissue or fat to buffer that pain. He also said that if entering posterior thru the back, that it is more invasive (moving nerves, cutting more bone away) to get the cage in place than going through the front anterior and inserting a cage. I actually agree with the second surgeon and plan to tell them I want to do the ALIF. I wanted to see if anyone has had the ALIF with a successfull outcome. It stinks having two different opinions from two doctors. They both agreed both ways could be done. But they both stood by the method they wanted to do. The first doc says that he is already in the back for the discectomy so why not just save a second procedure and do the cage for the back, but in my thinking, I agree with the less invasive of nerve retracting and the supposed higher fusion rate of a interfusion screw technology of the anterior approach. So confused as both methods could work. Any feedback on your own experiences with TLIF and ALIF would be great. Or any feedback of if two diff docs gave you diff choic what did you go with and how was your recovery? Thank you much for taking the time to read my post and post your thoughts and experiences : )


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    Spinal stenosis since 1995
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