I'm 55 years old and have been dealing with leg and low back pain on and off since 1986, when a moving injury decompressed and herniated my L5/S1 disc. So far I've managed to get by without surgery, and have had varying degrees of success with chiropractic, physical therapy, acupuncture, yoga, and just plain getting regular exercise. Every so often I'll experience a flare-up that requires an epidural injection to calm things down enough for me to get back on a rehab program. Last September, however, the shot never did give me the relief I was hoping for, and the worst New England winter in my lifetime didn't help matters. Finally a chiropractor abruptly stopped treating me and recommended that I see a surgeon.
First, I consulted with a surgeon known more for conservative, non-surgical approaches, who explained to me in thorough, concise terms that my disc had degenerated to the point where my vertebrae were nearly in contact, resulting in inflammation and ultimately pain. He suggested that I speak to a surgeon with a solid reputation with spinal fusion surgery. The leg pain I usually experience during a flare-up has been oddly absent, but new symptoms, such as extreme low back soreness when getting out of bed in the morning, have been perplexing to me. Unfortunately, they're also indications that minimally-invasive surgery isn't an option, and that I would need to consider spinal fusion to address the underlying issue.
ALIF seems to be the recommended option for single-level low back fusion, particularly for L5/S1. The surgeon has described it as a 90-minute to 2-hour surgery when performed in tandem with a vascular surgeon, and said that I could be on my feet on the same day as the procedure and back home after 2 days in the hospital. Reading this forum has been fairly sobering in that recovery time can vary widely for any number of reasons. IMHO, it's a good tonic to approach a major procedure with as much information and as many perspectives as possible.