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Recovering from recent L4-L5/L5-S1 fusion (PLIF)

WhatsTheJuiceWWhatsTheJuice Posts: 29
edited 06/26/2015 - 9:41 AM in Back Surgery and Neck Surgery
Hey everyone -

First post here. Not sure if this is the best place to put it, but would appreciate any help and answers, please. Thanks!

I'm posting the full details of my back issues, but you can just jump to the end for my questions if that is easier.

I recently went through a multi-level spinal fusion, fusing the L4-L5 and L5-S1 levels. I had it done by a neurosurgeon and he went in posteriorly. Used a piece of bone from my hip, only one scar, no complications and a better recovery than I expected. I spent a week in the hospital, and I am now 5 weeks and 2 days out of surgery.

-I am 30 years old, was always active, and have been dealing with back issues since the first week of July, 2006. I tore my ankle and within several weeks, had developed herniated disks at the l4-l5 level. They think I was overcompensating for one side of my body - working out on an apparent injury - and put so much pressure on one side that I developed the herniated disks. I specifically remember going up to school and needing the car pulled over five weeks after the ankle injury because the pain up and down my left leg was so unbearable. I had no clue what was going on. Didn't realize it was a back injury. Anyway, I developed degenerative arthritis not too long after that.

In the end, before my fusion (May 19), I had severely herniated disks at l4-l5 and l5-s1, some disk bulging at the same levels, obvious sciatica, degenerative arthritis in my lower lumbar and what the doctor said was degenerative disk disease. I know it's a broad diagnosis, but after my most recent surgery, a new MRI revealed that the side they worked on actually had the herniations return and increase in size.

This was my fifth surgery. The first four were lumbar dissectomies, two on L4-L5 and two on L5-S1. The first one was in Nov 07 and it helped. But I got reinjured and had another in Sept. 08. Again, helped, but two years later, needed another, and had one in Sept. 2010. Never really got much better, but life was livable. I then had my fourth surgery last August, when I couldn't deal with the pain anymore, and I got worse after the fourth surgery.

Anyway, to this surgery - The surgery itself went well. Considering the pain I went through after my fourth (all those years of scar tissue combined with the fact that I didn't use a single painkiller), I was terrified of this one. I woke up not feeling too awful compared to what I'm used to. I did use meds for the first six days of recovery, but they said I had to - and no way I could've gotten through this with just mmj edibles, which I did with my last one. Anyway, the first 4-5 days were a nightmare. Constant pain rush/panic attack a few times a day. Going to the bathroom was tough, getting up was so hard. Just a hell of a week, but I expected.

I went home after a week and have been taking care of myself since, getting a little bit better each and every day. Such a slow process. My surgeon has me wearing a big stabilizing brace for 12 weeks (I can take the big part off after 6-8). No driving or dog walking for eight weeks. No bending, lifting or twisting for 8 weeks. No outpatient PT for 12 weeks.

I'm doing the little bit of PT he wants me doing at home. Four leg exercises to keep my legs strengthened. I go for a short walk every day, and between that, making food, getting up and down to go to the bathroom, etc., I'm staying in bed 75% of the day like my surgeon instructed, but staying strong and healthy and active.

Anyway, a couple questions:

-How long until it's safe to sleep on my stomach? I'm usually a side sleeper anyway, but it's nice to just lay on my stomach sprawled out here and there. I haven't done so yet, and I try to sleep on my back mostly, but I also sleep in the fetal position occassionally with a pillow between my legs. I usually wake up each night to move to my back or side depending on how I'm lying down. I know I probably should avoid sleeping on my stomach for life, but just curious to how long you guys waited before even attempting to do so?

-I think it was successful surgery. I really do. My right leg feels better. My hips feel better. My back still has tons of surgery soreness and I know this is a long, long recovery where I have to be patient, but I do feel like my back will be significantly better (not "fixed," but better) when all is said and done. But my legt leg still has shooting sciatic-like pain. Is that often (I'm not looking for any definitive answers, as I know everyone is different) just recovery pain? I mean, I don't have disks there anymore, so the herniations are gone, but could that be permanent pain or possible just recovery? While I know it's only been five weeks since surgery, I also am trying to be patient and not worry about this pain. It's a sciatic-like shooting, occassionally radiating pain in my left leg. Sometimes weak, sometimes not. It has been getting a tiny bit better, but very slowly of late. I feel like I won't know anything for certain until I'm 10-12 weeks out and starting PT and really able to get back to living a normal life, walking the dog, twisting, bending, etc., but this one pain worries me. If my pain was at a 6-8 regularly every day of my life before this surgery - which it was - my goal from this surgery was to get down to a 2-3 max just for quality of life. I didn't have unrealistic expectations to be magically fixed or ever start really running again or anything, but I was strictly going for quality of life. Again, I feel like I'm going to be significantly better and despite the longest summer of my life, definitely worth it, which was one of my biggest fears going in -- the possibility of putting myself through something like this for nothing. No, I did not go into this surgery negatively like that, but I did have to prepare myself for all possible results. I wouldn't have gone through it if I didn't truly believe it would help, but I'm just curious to know how recovery went for people who had similar issues and had the same surgery as I did and if they experienced this kind of pain...and if I should just be patient and wait for it to get better because it's just surgical pain.

-Are they any restrictions and advice you would give me for 12 weeks out and for the rest of my life? I'm not going to run...I'm not going to play contact sports...I'd like to get back to playing tennis here and there, but it's not the end of the world. I would just like to be able to drive wherever without having pain get in the way, walk my dog without being in agony, not have pain interfere with work anymore, etc. But I am aware that without l4-5, 5-s1, that my l3-l4 disks are more succeptable to herniating because extra pressure is being put on them. Is that true? Because I don't want to ever go through this or any other surgery ever again. Is there anything I should know about those disks or precautions to take because the obvious stuff like sports and lifting heavy things etc.?

-Has anyone else been in the exact same situation as me? Those two levels fused? And if so, what was your end result? How was recovery and how is life now?

I know TL;DR, but this surgery was my last hope to ever feel normal again, and any help would be much appreciated.

Thanks in advance!


  • LizLiz Posts: 7,832
    edited 06/25/2015 - 9:04 PM
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    Spinal stenosis since 1995
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  • SavageSavage United StatesPosts: 5,476
    Please, I am just curious.

    What does that mean, " Bump for advice."....?

    Thank you!
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • Savage said:
    Please, I am just curious.

    What does that mean, " Bump for advice."....?

    Thank you!
    The few questions I posted at the end of my post....
  • Hey mate. I am almost 20 weeks out of a tlif at l5 s1 and still dealing with pain. It's a long journey with a different up and down struggle for each individual it seems. I'm trying to just deal with each day at a time. Working again, socialising, looking after 2 year old with most things. Going well but still got core spine pain in lower back area. Assume it's still the bone fusing, screws and muscles adjusting. No sex yet though... Still worried about trying that :0
    TLIF L5-S1 09/02/2015
  • Thanks for the reply. Hope your journey gets better.

    I had some concerts I wanted to get to in late August, and hope I'm good enough by then to make it. And I have a new job I'm starting in a couple weeks. I really hope to be good for all of those. I will still take it easy, but it would be nice to get back to my normal life.

    After five surgeries, though, I am not taking any chances.

    The no-sex thing obviously isn't fun. Jah feel.
  • PloughmanPPloughman Posts: 1
    edited 06/30/2015 - 11:58 AM
    I returned home from hospital yesterday after what appears to be the same op. My surgeon is very encouraging as was my PT and pain nurse, they explaining to me that many of the symptoms you are describing will come and go over the coming months. The varying leg symptoms pain, numbness, tingling etc. are a probably the nerves re-establishing themselves after being trapped/compressed whatever pre op and for so long. My pain nurse said they can 'fire off' every now and then and sometimes for a couple of days or more but they will eventually settle down. She said it was important to take the prescribed pain relief as this will also help reduce any muscle tension/ spasms that can cause more pain. She said that keeping the pain in check will reduce the 'cycle of pain' that might occur without them especially during the first few months post op.
    My Surgeon also said that after this type of operation the degeneration is basically fixed through fusion so eventually we'll be able to return to normal activity....he even said I'd be able to run again, play tennis and hike and much more. He said I could swim after the wound sites heal. He did say that with gentle PT I can increase my activity so I am really looking forward to week 4/6 to get started.
    As for the vertebrae above, L2 & L3, I too was worried from what I'd read - wearing and added stress on these bones but again my surgeon was reassuring saying it is unlikely if you keep doing the 'core' exercises, for life, to support the spine.
    Like you I appreciate that summer will pass slowly and like you it is so important to keep focused and positive. I do believe we also need to be very disciplined with ourselves too. Keep doing the exercise we have been 'prescribed', daily and little and often and within our pain parameters, eat a high protein diet to assist the healing, stop smoking if you do as nicotine drastically reduces the success rate of fusion surgery and to make small daily goals for yourself to focus on as these will give us a good feeling to reflect on at the end of the day.
    Good luck you deserve it and before long you will be walking your dog and perhaps participating in the odd game of tennis. Time is the great healer and we will get there.... :)

    Welcome to Spine-Health
    Please click on Welcome to learn more about SH and how to navigate this site to best benefit you.
  • Thanks for the reply. Glad to hear you're doing well and thanks for the information. My surgeon said no outpatient or real active PT for 12 weeks. I'm six weeks out today.

    I, too, would love to play tennis again. I miss it.

    I don't smoke cigarettes and never have, but have been using mmj edibles to get through the pain for the last five weeks after using opiates Week 1. I'm just hoping the back soreness subsides in the next 2-3 weeks and the leg pain is gone within a month or two. It definitely is a long road, and good luck with yours.

    I feel like it's definitely helping, but the sciatic pain in my left leg is nagging and six weeks is a long time to the average peron, so I have to keep reminding myself that a three month recovery is just what this is going to be.

    My main concern is just the leg pain. And you answered the rest re: future worries with other disks and back problems. I was mainly just curious to know if I should be feeling better six weeks out. Admittedly, two weeks out of surgery, I told all of my friends that I was WAY ahead of where I expected to be.

    I compare this recovery to getting a puppy. The first few weeks, you notice a huge, quick improvement from the day you came out of surgery, kind of like how a dog grows a ridiculous amount in the first couple months. Then it's a slow, steady, very gradual recovery, getting a tiny, tiny bit better each day, like when a puppy's growth starts to get very, very gradual and only noticable week by week. If that makes sense...I'm not wording it too well, but I think it's a decent analogy haha.

    Thanks again and best wishes to you.
  • I love your puppy analogy!

    At about 12 weeks, I started sleeping in my usual semi-stomach position., one leg straight and one leg bent and pretty high up. I was so happy to get that little bit of normal back. It hasn't seemed to do any harm. I am still hesitant to be absolutely flat of my stomach for too long.

    I didn't have hardly any sciatic type pain pre-op, but I have had a lot of it post-op, so surely it has to do with recovery. Numbness in low back/butt area is also included. I noticed the numbness gets worse when I have been up and doing too much.

    I have found, just through posts, YouTube, etc. that physically fit people seem to recover more quickly. Unfortunately, I can't include myself in that group, so it is taking a long time to get more back to normal.

    Something we all have to remember is that until we actually fuse, we should be more careful. I don't want to screw that up. :)

    Posterior Lumbar Interbody Fusion (PLIF) Surgery (Open) L2/L3 (23Mar15)
  • Don't be surprised if you suddenly have problems with muscle spasms. They seemed to come out of nowhere a few months after surgery. I guess they are caused by trying to use those muscles more after surgery. I don't really know.
    Posterior Lumbar Interbody Fusion (PLIF) Surgery (Open) L2/L3 (23Mar15)
  • jdwinkler said:
    I love your puppy analogy!

    At about 12 weeks, I started sleeping in my usual semi-stomach position., one leg straight and one leg bent and pretty high up. I was so happy to get that little bit of normal back. It hasn't seemed to do any harm. I am still hesitant to be absolutely flat of my stomach for too long.

    I didn't have hardly any sciatic type pain pre-op, but I have had a lot of it post-op, so surely it has to do with recovery. Numbness in low back/butt area is also included. I noticed the numbness gets worse when I have been up and doing too much.

    I have found, just through posts, YouTube, etc. that physically fit people seem to recover more quickly. Unfortunately, I can't include myself in that group, so it is taking a long time to get more back to normal.

    Something we all have to remember is that until we actually fuse, we should be more careful. I don't want to screw that up. :)
    Good to hear about the sleeping. I will look forward to that. My main concerns are that I'm starting a new job, one which I can work from home a lot, but will need to drive and be places and be sitting for long periods of time meeting with clients. I don't want the pain to get in the way, or not allow me to go somewhere. And just a sidebar, I have some concerts I'd like nothing more than to attend in August. The first ones are exactly 12 weeks out (the approx. time to "get back to normal life") and the others less than two weeks later. I'd like to end my summer with at least some fun and be at those. Having said that, I will never risk my health for music. I'm just hoping the next 4-5 weeks get to the point where I can wake up and not feel like I even had surgery. The "depleted" and initial "beat up" feeling sucks after surgery. It's like you're tired, but you're not. Body-wise.

    Your part about having sciatic pain post-op is very, very reassuring. Thank you. And yes, when I'm up for too long - or even sitting in a seat with the brace on for too long - I need to lay down and I feel pain and I guess some numbness and spasms. That's good to hear at least for my personal recovery - and from a down-the-road standpoint, as it's just recovery pain and nothing too major to 100% worry about.

    And yes, I've had random muscle spams. Some when I was out of bed for too long and in pain and just needed to lay down. But definitely random little spams (not too painful or anything) in certain muscles that took a few minutes to go away. I figure you're body is working differently.
  • I think that a positive attitude really goes a long way and it sounds like you have that. :)
    Posterior Lumbar Interbody Fusion (PLIF) Surgery (Open) L2/L3 (23Mar15)
  • jericho163jjericho163 Posts: 44
    edited 10/24/2015 - 12:06 AM
    ya i also got sciatic pain after surgery, but it drops like 5% everyday!

    back muscles still sore though.

    how is everyone doing
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