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L4-L5 TLIF postop course



  • I am now in postop week 4 after my L4-L5 TLIF.  I still have pain in my back and my left leg.  I also have numbness in my left leg.  It seems like I have more pain now than a week ago.  I'm thinking of might be from my doing a little more around the house being mindful of no BLT.  I saw the neurosurgeon a week ago and he said the X-rays show everything is in place.

    I can walk around the house without a walker.  I can walk 50 to 100 feet with a walker outside the house.  I take one 5 mg oxycodone at night.  I also take acetaminophen and gabapentin.  I cannot work and applied for Social security.  My focus is not to do anything that will hinder my recovery.  My pain lying down is 2-3/10.  My leg pain standing and walking is 5-6/10.

  • I want to provide an update of my condition as I recover from my L4-L5 TLIF.  I am now at week 7.   

    It feels the pain in my back and legs have gotten worse over the past couple of weeks.  But I have good days and bad days.  On a good day, I feel like I am recovering and things are gradually better.  On a bad day, I have to lay on my heating pad most of the day. 

    On a good day, I would say I am better after the surgery.  On a bad day, I think the surgery didn't help much.  But I also know I am still early in recovery.  I have about 3 good days and about 3 bad days a week. Pain is about 3-4/10 on a good day and 6-7/10 on bad days.  I have pain in my lower back and legs (left>right).

    From what I have read in this forum, I like to be optimistic and think the ups and downs are normal and that I will continue to improve.  I also think the ups and downs might be due to my efforts to do more and that I don't know when I have walked or stood too long until the next day.

    I am glad to report that I have stopped all oxycontin.  My only medications now are gabapentin, Tylenol, and melatonin for sleep.

    I still have to sleep flat on my back and it's very hard.  Some nights I don't sleep at all.  Lying on my side causes pain.  I can't wait until I can sleep on side again!

    Inside the house, I can walk without a walker of cane.  When I go outside, I prefer to use a walker, it give me support.  I am still wearing my back brace.  I am careful not to bend, twist, or lift.    

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  • I am writing to provide an update of my recovery.  It's been 3 months since my L4-L5 fusion surgery.  It was my second surgery, the first was a L4-L5 discectomy that wasn't fully successful as I had persistent severe pain.

    With what I have learned from the other posts in this forum, I understand that recovery is a long process that will take many months.  The phrase I use to remind myself is "It's a marathon and not a sprint."  I would be totally discouraged if I didn't hold on to this perspective.

    Overall, there has been a trend of gradual improvement with intermittent set backs.  I am now only taking Tylenol 650 mg twice a day with gabapentin 100 mg in the morning and 200 mg at night.  The pain is noticeably worse if I skip any doses.  With the medications, my pain is usually about 4/10.  The pain is in my lower back and left leg. 

    I still have the weakness and numbness in my left leg (that I had before the surgery).  The pain in my right leg is minimal.  I was using a cane until I realized it was causing pain my right shoulder.

    Because of pain and inability to turn my body, I don't feel safe driving.  I can walk about a half block before the pain gets worse and I turn back.  I can only sleep flat on my back; sleeping on my side causes pain in the lower back.  I have not been able to return to my desk job since I can only sit for short periods.

    A most aggravating part of the recovery is that I have 2 to 3 bad days of severe 7/10 pain about twice a week.  On the bad days, I'm on the couch with my heating pad most of the day.  I realize these bad days usually follows days when I try to do too much (e.g. walked too long a the store; sitting too long visiting family).

    I am praying that the fusion is progressing appropriately.  I am still wearing a back brace because it feels better to have the extra support.  I am scared to do anything that can jeopardize the fusion process so I am continuing with the BLT restrictions.  I just started physical therapy last week.  I will get xrays and see the neurosurgeon in 3 weeks.      

    I am better now than before surgery and hope the trend of improvement will continue.  At the same time, I am very afraid that the spine is not fusing properly.  The xrays next month will tell.


  • I just want to provide an update of my progress since my L4-L5 TLIF done 10/15/2018.  I am now nearly 7 months post-op.  I haven't written an update for awhile because I have been very frustrated.  I can no longer tell if I am gradually improving or getting worse.  I have good days when the pain in my low back and left leg is a little less.  Then there are other days when the pain is bad all day.  I can't figure out what I do that brings on the days with bad pain.  I may have 3 to 4 good days one week then 1 to 1 good days the next.  I also have sever pain at the end of day starting around 6:00 pm, on both good and bad days.

    When I had the surgery, I was hoping I can improved to the point of returning to work.  I have a desk job that requires sitting and concentration; most of my work is with a computer.  Because I don't think I can work (can't sit very long) I have no choice but to apply for retirement.

    I know most people would say that 7 months post-op is still early but it seems like an eternity.  I hope I will continue to improve but I'm starting to have my doubts.  My pain, when it's bad it about 8/10 mostly in my left leg (the same place I had pain before the surgery).  I have also had some intermittent pain in both knees and at the right leg that is not severe.

    I bought a new mattress and pillow and am able to sleep better.  On a good day, I can probably walk a half-mile.  On a bad day, I can't make it around the block.  I am still having weekly PT.  I also started acupuncture.  My only pain medication is Tylenol two times per day.  My friends have recommended a CBZ rub and I will try it.

    Despite the slow and discouraging progress, I am still better now than I was before the TLIF.

    I continue to remind myself that it's a marathon and not a sprint.

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