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PLIF L5, S1 Recovery Question

mudfootballmmudfootball Posts: 6
edited 06/11/2012 - 7:52 AM in Lower Back Pain
Hello Everyone!

It's been a while since I've last posted. I just had my PLIF surgery on January 17, 2011 and wanted to know if I am still in the early stages of recovery. I feel ok but just can't stand only for a short period of time. I basically feel the same as before my surgery but without the calcified disc pressing on my nerves. Before surgery, I was able to walk but couldn't stand for long and had my nerves were pinched. Is this normal to be in pain at this stage while standing? I have been walking a lot. Around 6-8 miles every week. I can walk all day but have pain from just standing. Are my muscles still healing that is causing this pain? I just had my 6 week checkup and my Dr. says that everything looks fine. He said it was normal to have this kind of pain but I wanted to get opinions. Thank you!

33yr old male, 6'1" 225 lbs


  • I'm not a doctor, of course, but I'd say it's very normal to still have discomfort after such surgery. I still have issues and I had my surgery last July!!! It's still very early in your recovery.

    Walking was the best form of exercise for me also. I felt like I could walk for miles, but sitting for any length of time was painful (and still is if I'm honest). When I stood still, I could feel the pressure on my spine and it was painful, but I tended to shift from foot to foot if I couldn't walk around (you know, like when you're at a meeting at work talking to someone, you can't just walk away, so shifting from side to side relieved it a bit).

    My surgeon said that my recovery can take up to TWO years for all the nerves to settle down and for the spine to fully fuse - has your surgeon given you any guidelines on this?

    Are you going to start physiotherapy? I tried that first and then was referred for hydrotherapy - that was very good. Swimming is also a great form of exercise that helps to improve your 'core' strength by improving the muscles that support/surround your back.

    It's great that your doctor said everything was fine at your 6 weeks check-up. If you've got any concerns, perhaps you should ask him/her for reassurance and discuss what options there might be for you to have therapy sessions (but it may be that you haven't started them yet, I didn't until I was 3 months post op).

    Hope this helps you.
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • I appreciate your response. It does help me understand what I'm up against.

    Once my surgeon viewed my X-rays, he said everything looked good and that he doesn't need to see me anymore unless I need him. He never told me about any therapy, just to walk and stretch. However, I am exercising more and more each week. I will soon join a wellness center that has an aquatic pool. Maybe that will help me more.

    Thank you again for your response and best wishes on your recovery.

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  • Really glad I found this post, I'm 7 days post PLIF L5/S1 and anxious to know how long I can expect my recovery to be. Will watch this space for your progress mudfootball
  • cshulverccshulver Posts: 1
    edited 04/12/2014 - 2:48 AM
    I had surgery last August and immediately felt the main left 'big' sciatic pain was pretty much gone and the wrenching tortion felt with that pain is pretty much gone. However the lesser pain on right side is not much better, Immediately after op I realised I had right side pain in back and legs when the left was numb- the epidural worked only on 1 side! The anaesthetist joked that my nerve roots were such a mess that I was lucky it had worked at all. I saw consultant before discharge- he was very pleased with the surgery and showed the xray which looked good and solid, so I questioned the advice not to bend forwards. He reassured me the fusion would be fine, but try and avoid it. When I bend- I do so at the hip not back as I am hypermobile- so if I was comfortable it was ok. I
    can bend easily and I do not feel pain while bending down- I feel pain upon straightening and cumulatively thereafter along nerves. My surgeon could see no reason I should not have been able to return to full duties after intitial period of lighter work. In fact a fusion needs to be used to strengthen it. Upon discharge I could walk easily and on day 4 walked at least 2 miles in one go and at a good pace. I was great for a couple of week further, and managed to get cat to vet and back but then my recovery halted, no better, no worse- but still alot better than pre-op. My physio started 6 weeks-all was ok. Had 1st check up around week 8- registrar pleased with progress. Week 11 fell during theft attempt on bag!- went home no problems until following week. Had xray- was no further action- (but was not compared with post op one). Nerve pain was increasing, which meant I could not return to work for week 13. Employers insist I make appt with consultant- I saw same registrar again, which is annoying given the travel costs. He could not access recent x-ray, however, upon examination it was clear I was making good progress. I enquired as to why I was getting worse now when I had been better. He explained the nerves which had been moved during surgery will take a few weeks to cause pain, and it is expected, He also advised that I should not go back into job that involved a lot of bending and lifting as risk to other levels increase. Which contradicted other advice- I also have no problem lifting any more than the bending and straightening required in the first place. Why this is not advised at discharge he could not say. Nerve pain steadily increased especially at night, it wakes me up even after a lot of meds. I am still better off as I am fine walking- standing still an issue, but is more tolerable now. I am now on more meds than pre op and use gym 1-2x per week. Why are patients not advised that symptoms will get WORSE before they get better. I am so variable now from day to day I dare not make commitments (beyond appts) as I cannot guarantee sleep or function, I also have an issue with mornings due to medication. I was always an early riser- now I am more like a bum. I had a CAS appt for referral to pain clinic referral for nerve blocks hopefully. CAS dr also alluded to a delayed reaction from nerve insult during surgery, but on the whole seemed unqualified about this issue (But it made sense that after the vertebra slips and the nerve roots are squashed and stretched, it takes a few weeks to feel the pain radiating down the legs, so after added metalwork and structural work on spine disrupts nerves in the same way)- he was still training and could not prescribe yet. So was happy he referred me on to pain clinic, though I had wanted to see a neurologist for right side pain and bladder retention as well as worsening nerve pain. I guess it is just symptoms they have to go by now as the structural defect is now repaired. I hope this worsening is just temporary- I would be interested to hear opinions and experiences.
  • If the bladder retention is new, since your surgery and you are having more nerve symptoms, it is something that you should discuss with your surgeon. Bladder retention when it didn't exist prior to surgery can indicate that there is further compression of the spinal nerves in the canal, so it is something you need to be evaluated for by the surgeon who did your surgery. Yes, nerve pain can and often does flare up after spine surgery, and I am totally lost as to why your surgeon would tell you that bending, and lifting are okay........
    Every fusion patient that I have ever seen has been told no bending, lifting or twisting until the surgeon okays it, and yes, patients should be told that when the nerve is compressed prior to surgery, to expect a flare up of nerve pain for the post op period.....it hopefully will disappear as quickly as it appeared.....but there are several medications that might help to ease some of that pain in the meantime- lyrica, gabapentin , cymbalta and a few others are commonly used to treat that type of pain.
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