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ALIF OR PLIF...How did you decide???

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:23 AM in Back Surgery and Neck Surgery
I'm waiting for the Doctors to schedule my surgery. I've decided on ALIF.

I just wondered about others. How did you decide which one, front or back?

For the ones that had ALIF, did you have any complications as far as your major veins in your legs, blood transfusions...etc??

And the ones that had surgery from the back, did it take longer for your back muscles to heal...so they seem to recover fully as far as your motion from the muscles being cut? Was it more painful?

Just wanted to think that I made the right decision...I'm having a fusion at 1 level: L5 S1. I'm 38 & weigh 134 lbs.



  • Hi Kristie!
    I didn't have a choice. My doctor performed my surgery from the back because he thought that was the best option for me. As far as muscles, I think that it would be the same either way because the core muscles are being cut in both surgeries. I did have to have 2 units of blood the day after the surgery. As far as pain, I'm sure the amount is subjective to the patient but I'm sure it's bad either way. That's why most patients are given a pain pump in the first few days after surgery and then sent home with pain meds. If you are confident in your doctor and you have a good feeling in your gut then you probably made the right decision. If you are not sure, you can get another opinion. Spinal fusion, no matter how it's done, is major surgery and every one recovers differently from it. Good luck to you and ask away if you have any more questions.
  • I would think the surgeon should decide. My NS prefers ALIF, but said it was not an option for me because I had an unstable PARs defect, so it was PLIF. I have heard ALIF is an easier recovery, but from what I read here, sounds like it is tough either way. I know my ceserean was much easier than my PLIF, but that is not much of a comparison. For ALIF you will need a general surgeon to assist, perhaps talking with them will help you decide. If you have any previous abdominal surgeries, there is a risk of scar tissue in your abdomen. Good-luck, Sue
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  • condition which the best approach is for you and your injury. SO I wouldn't even look at it as if it was my decision but the surgeons.

    Sara O:)
  • Hi hun,
    Everyone hit it right on this one.
    It is usually the Drs choice. He knows what is best for your body and medical history.

    Some Drs well yeah they give you an option. Most do not.

    Personal choise the PLIF. Iv had 2 c sections and well the 2nd one was much tuffer of course because of it being 2x's and I was a bit older.
    Plus all the other cutting open they have done on me sideways etc..

    Just remember in a ALIF they have to move everything to the side and get it out of the way due to the levels you are getting done.
    With the lowest of levels that your doing the back approach in my mind is the easiest. In my Drs. to.
    I needed no blood transfused at all.
    But everyone is different when it comes to a major surgery.

    As for your question on core muscles well I did not have a issue. I did not have to wear a brace (which prevents you from using those muscles so you do not bend and twist) and I did not have to do physical therapy. Sore yes. I had my surgery on Sept 9th and was passing out Halloween candy Oct 31st sitting outside (up and down) etc. So I was still sore and weak. BUT DID IT!! :D <:P <br />

    Good point Paul made. Ask the Dr what he prefers and what he would do for a family member. Always gets to the Drs w/ that question!! :jawdrop: :D

    Sorry for a long rambling post. But it is 5am and yes I am up!! 8} I) 8} I) 8} I)

    Take care and GOOD LUCK on your decison!!
  • Ok, I had asked the Dr which one he would get if it was him. He said he would have it from the back...due to his large size. He said I would do great from the front, because I was "skinny'. He said I had to make the decision...he could do it either way.

    I've already had 2 c-sections myself. 1999 & 2003.

    Thanks for your comments!!

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  • Glad you asked.
    See knew you would get a response!

    Yes its up to you. Let us know what you decide.
    To me it was not painful to lay on the incision as I had just glue and no staples/stitches. So it made for easy rolling not having to hold the belly. That is also another thing I would ask. Stitches/staples or glue........

    GOOD LUCK!!! <:P >:D< >:D< >:D< >:D< >:D<
  • Hi Kristie:

    I pretty much agree with the others. Your doctor will decide what is best for your particular case, I was not given a choice. I had a one level TLIF fusion, from the rear, September 2007. Unfortunately, one week later I had to go in for an emergency colon repair surgery, that was done from the front...so I got it from both sides. After the colon surgery I needed two units of blood. I think in any case, your core will be "compromised" and you will need to exercise after to regain that strength. I am 58, 114 pounds, and have recovered very well. I fused within 6 weeks.

    I wish you the best.

  • Hi Ellen, I have seen you mention your emergency colon surgery several times in various posts. I keep wondering, if you don't mind answering, was this a complication of your TLIF or unrelated? I did read something about possible internal damage from the doctor puncturing through the far side of disc-space while removing the disc material. Just curious :? , Sue
  • I have had both and I would strongly advise the ALIF. They cut the abdominal rectus muscle the same way the muscle naturally runs so the abdominal muscle recovery wasn't bad at all. With the PLIF I am having a lot of back spasms due to cutting the back muscles and the reovery is a bit slower. With the ALIF they do have to move things to the side but I had no problems with it. Gods Blessings on whatever you decide.
  • Hi Cali Sue:

    No, unrelated. The surgeon more or less said it just happened. I had my TLIF on Friday, went home from the hospital on Tuesday. Starting about Thursday I got stomach pain and it just continued to get worse. I was getting home nurse visits and they couldn't figure out what was wrong. At first everyone thought I was constipated from the narcotics and I had the "usual" remedies with no relief. Finally, Saturday, I could not stand the pain any longer and my doctor advised me to go to the ER. A good thing I did, they said I could have had a rupture which might have been fatal. They ended up repairing a tear. I was in the hospital until the following Thursday. I remember people asking me how my back felt...I said, compared to my stomach pain, "no comparison". Actually, after the pain prior to the colon surgery, the rest wasn't so bad.

    Aren't you glad you asked..I wrote a BOOK!

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