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3 Month Post-Op Update: L5/S1 Single Level TLIF

MarkRMMarkR Posts: 172
edited 06/11/2012 - 8:25 AM in Back Surgery and Neck Surgery
I had my 3 month post-op appointment this morning - two days earlier than expected. He said I am doing great - much better than most of his patients are doing at 4-6 months out. Everything looks good and I also got some additional information that may be of interest to some of you.

First, my BLT restrictions have been lifted, but there should be no repetitive bending or twisting. Lifting is limited to no more than 25 pounds. My surgeon gave me a series of exercises that include using 8, 10 and 12 pound weights (4, 6 and 8 pound weights for women) . I can also do some light Pilates exercises. This is a home program - no PT with a therapist. I also no longer need to use my brace, though he said I should wean myself off it, so I'm not completely stopping yet.

The following are additional details:

X-Rays: Everything looks good. There is no sign of bone growth yet, but my surgeon said not to expect anything to show until 8 months to 1 year out. He said there is no sign of slippage and that there probably is some bone fusion taking place, it's just not visible on the x-ray. I had facet bolts used instead of rods and screws, so both sides of the vertebrae are essentially fused anyway. I guess some of the techs said my x-rays were "cute" because there are only 2 small bolts instead of 4 screws and 2 rods. :)))

We discussed my pain level, which increased after my last appointment. It started after the swelling went down and I switched to a soft corset brace. The pain is at the top of my rear end (below the surgical site) with occasional pain down my right leg. At times it feels worse than before the surgery, but most times it is tolerable, though worse than at the 4-5 week time period. He said the pain is due to the lack of muscle use in the lower back and also due to inflammation - fluid in the area that sometimes presses on the nerves, causing the shooting pain down the leg.

My surgeon said this is all normal and will subside over time. He said the key is to get the muscles working again, and to increase flexibility. He said for the first several weeks of the exercise program, I can expect the pain to get worse (this is no surprise), but then it will gradually get better. I have been using Darvocet and Soma - he said to continue with those if they help, and also gave me a script for Vicodin, which may be necessary when starting the exercise program. The key to not overdo it - start slowly and build up to a more intensive program. If it starts to hurt, stop.

Another exercise he recommended is whenever I go into the kitchen, put my hands on the counter for support and do 10-20 squats. Not only is this a bit of exercise, but it allows you to get to items in lower cabinets with little to no bending, therefore putting less stress on the discs.

During my recovery, I got a copy of my MRI and asked him about some of the findings at other levels of the lumbar area. He said they are nothing to worry about. I asked him what I can do to not aggravate those discs and try to make sure I don't have to go through another fusion at other levels. The following is a list of things that will help:
  • Smoking: none
  • Drinking: none to little - definitely in moderation
  • Weight: maintain proper weight
  • Exercise: very important, especially increasing flexibility
These are all things we have control over and help delay the natural aging process. As we know, the natural aging process will cause some disc degeneration that may lead to fusion surgery. He said there are genetic issues such as Diabetes which can also have an effect, but they are not something we can necessarily control.

Referring to my post from last week about anemia, he said my low platelet count has nothing to do with the surgery, so I will continue to deal with this issue with my PCP.

Based on our discussion, it seems like the most important thing during recovery is something that is very difficult and something we have all heard before ... BE PATIENT.

I hope that some of this information is useful and may provide hope that things will improve for you in your situation - it just takes time.



  • Mark, it is great to hear you got a good check-up :) . Brace weaning and exercise will definitely flare up pain so get that script filled ;) . I started with upper back pain and SI joint issues when I got out of my brace and started PT. My doc doesn't usually order PT, but I asked to go. I knew I would have better follow through with it then doing my own thing. I also go to the pool at the YMCA. Take it easy and add these exercises gradually. Start with few reps and work your way up. Good-luck to you. Hopefully that platelet thing was just a fluke. >:D< Cali-Sue
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