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Multi-Level "ALIF" Fusion (L4/L5 + L5/S1) Questions

AKpatient0AKpatient0 Posts: 30
edited 12/08/2015 - 2:15 AM in Back Surgery and Neck Surgery
"Long time listener, first time caller"

38 year old male, severe back pain with leg pain for last ~5 years following pre-deployment training and subsequent deployment to Afghanistan. Some of it looks degenerative, but some of it is also injury related.

After years of conservative, non-surgical treatment, today my surgeon said that I need a multilevel fusion @ L4/L5 & L5/S1. Well, he alluded to it a month ago, but today he confirmed it. He stated that he recommends the Anterior lumbar inter body fusion (ALIF) method.

It's not yet scheduled, but it looks like I'll be going under the knife mid-to-late January.

What do I need to know? What should I expect post-op? Throw anything and everything at me. I'm a pretty active person and still in the military so being active is pretty much a condition of employment.


Welcome to Spine-Health

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Specific comments :

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--- Ron DiLauro, Spine-Health System Moderator : 12/08/15 08:15 est



  • hvillshhvills Suzhou, ChinaPosts: 732
    I've had 2 fusion surgeries in the past several years... the first a double level L4-L5-S1 PLIF. The post op recovery was slow and longgggg but I was pretty much pain free from the time I woke-up. The second (with the same surgeon) was a completely different story... I woke up with ALL the pre-surgery nerve pain and more. It took 4 months of misery for the nerve swelling to reduce to a level where the pain subsided. Hopefully your experience follows the pain free path... but if it doesn't don't get discouraged as the nerve healing and swelling reduction is a SLOW process and can possibly take months.

    The biggest lesson learned for me (the hard way) and really isn't part of the immediate recovery is that even once your fusion is complete and you are fully healed you still MUST BE "kind to your back" for the rest of your life. The fusion surgery will cure your nerve pain but your spine won't ever be 100% again. The bone jarring and stressful activities you did before the surgery need to be eliminated or approached with caution.

    Did your surgeon say he was going to include posterior stabilization screws and rods?
    Harry - 63 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • He did mention that there would be screws and other hardware, but said that his approach/method would only be from the anterior. So, I'm unsure, at this point, the location of the screws and other hardware. Thanks again for your input. I am trying to stay positive through this whole endeavor...
  • AKpatient0AKpatient0 Posts: 30
    edited 01/06/2016 - 5:33 PM
    Well, I'm about 3-1/2 weeks out from surgery. I'm scheduled for a multi-level (L4-L5-S1) ALIF (cages, screws, rods, etc.) and decompression on 2 Feb. It's been a long road to get here having tried just about everything less invasive to relieve my pain to no avail. I'm hopeful that the future will bring reduced, manageable pain. My issues are both degenerative and injury related. As I stated earlier, I'm a male, only 38, on active duty in the Air Force so I'm hopeful my age and relative good health help my recovery, but this surgery may make it so I'm unable to continuing serving this great nation...at least with my current employer. I can't help being somewhat scared about the surgery, the long/tough recovery, and the possible negative impacts it may have on my military career, but I'm approaching this (surgery) as good thing with a positive attitude. This page and its forums have been more helpful than I could have hoped for.
  • hvillshhvills Suzhou, ChinaPosts: 732
    You're young and a strong military man... you will come through the surgery like a champ. Below is a link to another military guy who absolutely blew the pants off the normal recovery cycle. His nic name is Superman... Your goal is to do better than him...!!!

    Harry - 63 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • DO IT!! DO IT NOW!!

    Ok...I had ALIF at l5-s1 15 months ago. I was a police officer of 18.5 years, was injured on the job; work-comp case. I went through all the injections, epidurals, nerve ablations...you name it. Finally got work comp to agree to pay for surgery (took over 3 years). Disc removed, carbon fiber cage put in with 3 screws, 1 top and two bottom, filled with synth bone material. I wish I had gotten this done years ago. All the stabbing/electric shock pain was gone immediately. I have some left over nerve pain in the right butt and leg, and a little dull ache in the low back, but nothing like before.
    This injury, along with a neck injury (c6-c7 fused in 2012) forced me into a disabilty retirement from the PD in 2011...

    You should be able to return to normal activity within weeks, with the exception of running and any harsh physical activity. Full and complete fusion won't be until 1 year post op, technically, so for a year you have to take it easy...Your first 6 months will be up and down...good days and bad days.
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