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Questions for 360 Lumbar Fusion Patients

itsbettinaaaiitsbettinaaa Posts: 28
edited 06/11/2012 - 7:53 AM in Back Surgery and Neck Surgery
Hello again everyone. I just have some questions.

Quick version: To those who've had a 360 lumbar fusion, what is the healing process really like? What I would like to know is stuff like how long were you told you'd be out of work vs how long you actually were out, how did you find a comfy position to lay in without hurting either incision site, and anything else you can tell me about the healing process.

Long version:
I am only 21 and a 360 lumbar fusion(L4-L5) will be my first surgery ever (great first pick, huh? haha). I am really nervous and my surgery is scheduled for July 25 so I have a long, anxious wait ahead of me!

So regarding the healing time, my surgeon said that people with jobs like mine (receptionist) usually return to work in 6 weeks. When he said that I needed to pick my jaw up of the floor. I've read a lot of other posts that people are out of work at least 8 weeks, and even then they can't tolerate working.

I have been trying to find threads on this site with 360 patients but there just aren't too many (or if there are, I can't find them!).

I know there are tons of posts about helpful things to do while healing but I was also wondering if you could tell me which did you find most helpful.

Also, does anyone know if the healing process of a 360 and a PLIF or ALIF are very different? If they're not then I guess I can just keep scouring up as much info as I can.

I apologize if this post is choppy and written horribly. It is 4am, I've gotten 5 hours of sleep in the past 2 days, and I took a pain pill. I'll probably kick myself later for even posting something as ridiculous as this probably is lol.
Thanks in advance everyone!


  • my consultant has told me that when i have my ALIF {360 fusion} it will take at least 12 MONTHS to heel then another 24 months to feel better so that's 3 years .and i have one of the uk's best consultants .i am sorry but 6 weeks is far to ambitious ALIF surgey is massive and requires a lot of rehabilitation .and even though you have a sit down job i would say that you would need at least a year of work . i was surprised too when i asked how long recovery would be ..i suppose it depends on the state of your spine .but my consultant who operates on most of the uk's north patients recommends that recovery takes around 3 years .and if you are no better by then ..you wont get any better ,and he is a very reputable consultant with a massive waiting list .and ALIF or 360 is the same operation it stands for anterior lumbar interbody fusion .and is done through the abdominal wall either by open method {wiltse} or through laparoscopic {keyhole} PLIF is done from the rear and stand for posterior lumbar interbody fusion i am sorry if i have upset you but i am only passing on what i have been told i cant mention the consultants by name but he is one of the uk's best .there are many threads on ALIF surgeries on here just type in ALIF in the search box .and you can google any more info should you require it ..ALIF seems to be the flavor of the year right now .when i had my first operation it was laminectomies in the 1990 then in the 2000s it was discectomies now everyone's having ALIF /PLIF surgey .considering your age are you not a candidate for ADR ?? artificial disc replacement ..maybe you should get another opinion?? anyway good luck with whatever you do
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • First I want to thank you for your response.

    A 360 fusion is a ALIF and a PLIF together. They will do one incision on my stomache and remove the disc/put in bone graft/other stuff I can't remember, then they will make an incision on my back and put some screws in.

    Now as for that 3 years info...I'm kind of speechless. Did this consultant say healing time is up to 3 years or time off work is up to 3 years? I know that it take about 6 months for the bones to fuse but because of the instrumentation that will be inserted and possibly a brace (not sure of I will need one) there should be no reason to be off work for years.

    As for the ADR, in America it is still considered experimental so insurance companies are not covering it. I was offered to be in a clinical trial and get the surgery for free but I was disqualified because of my DDD at a surrounding level :/

    The surgeon I am with now was my other opinion and he discussed my case with his whole team and they all agreed on the fusion so I am comfortable with that choice.

    Thank you again for responding :)
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  • i was unable to have ADR as i have arthritis and DDD and other problems .but ALIF was the only option .my consultant told me that the ALIF procedure is about as big as it gets and regardless of what anyone tells you it dose take three years to heel fully .you may feel ok in about 6 months but your back wont be very strong .he advised me that after 12 months i could do small amounts of normal living .but told me that it would take another 24 months to get as good as it ever going to be .he also told me that i would never work again due to the state of my back .and ..this is very important ..the ALIF on me ..is being done to prevent any more damage its not to stop pain ..if the pain eases that will be a bonus .that may not be the same for you .i may be a special case .i know that 4 other consultants would not operate on me {as i have been operated on twice before} and they have made a mess of my spine .my consultant is renowned for operating on end stage failed back syndrome.many consultants wont .i was surprised too when i asked about the three year recovery .but that's what he said .and he also said if anyone tells you any different dont believe them! as in his words quote ..i have seen enough bad backs in the last 30 years to know what i am taking about ..end quote . i am 45 now and with you being younger ,recovery may be shorter .i hope it is .good luck with it any way
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • First part of your post that caught my attention is that you are 21 years old and having a fusion. Unless you are in a bad place with dealing with pain, 21 is very young to have a procedure like this done. Did your surgeon say if microdiscectomy or something less invasive could be done first?

    In my case, I went back to work at about the 6-8 week time frame. That was way too soon. 12 weeks would have probably been better for me. But, I also had a two level 360 ALIF done.

    I had a lot of rehab afterwards. Water therapy was by far the best for getting me up and moving again after surgery.

    I was told that it would take about 3-6 months for the fusion to be solid. I was able to slowly get back into the swing of things. Bottom line, if it doesn't feel right, don't try it. Try to avoid activities that require BLT on a repetitive basis. I was back coaching baseball (on a limited basis) at the four month point and was camping out with my son at camp six months afterwards.

    I found sleeping on my sides with a pillow between my knees was comfortable after surgery, but laying on my back was possible again after surgery. Only log roll over after surgery! Don't try twisting yourself around in bed. I don't want to make this post too long, so feel free to PM me if you would like more information.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • I did L4-S1 360. My surgery was 1-20-2010. I believe I was still using a walker at 6 weeks out. I worked very hard to make the most of my recovery. I had a lot of PT, and walked everyday. I have to say that it was more painful and harder on me than either of my other 2 surgeries. I got feeling in my leg, but did not get much relief from pain.

    I was so grateful that I read the post on what I would need post-op. It was a struggle to get comfortable for a while. I spent much of my time in a recliner or in bed to begin with. I guess I still do. Cold packs and heating pads helped me. I don't use the cold packs much anymore, but I still use the heating pad.

    I was back to work on the factory floor @ 6 months. Work is still a struggle for me, but somehow I manage to get thru each week. I have missed a day here and there because of pain, but have not taken any extended medical leaves since returning to work. I am still taking a lot of medication. I have given up most physical activities outside of work. I am able to deal with my pain better now, but I am very cautious on what I do, and how I do things now.

    I tried to answer what I could for you, but I am sure I missed something. I am not here as much as I use to be. If you want to know anything else just ask. This site really helped me, and I still stop by to chat or read the boards. So I guess I am still getting support here, or validation that I am not alone. Either way I wish you the best.

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  • Keith-Unfortunately a microdiscectomy would not work in my case. The surgeon explained to me why the fusion is my only surgical option but it's too long to write out here. Also, the fact that I am only 21 makes me want the surgery even more. I can barely work part time, I can't attend school, and I've lost basically all my friends. I feel this is my last option and at this point I am willing to give it a shot. Thank you for the sleeping tip and the water therapy info. I've read a lot of posts on here that say water therapy is the best so that is something I am seriously considering getting into after surgery.

    Norm-thank you for your input. I have a question for you. Are your back muscles still really stiff after the surgery amd is that why you are using heat rather than ice? Also, immediately after the surgery, which did you find helped ease the pain better, heat or ice? I was shocked to read that you were using a walker at 6 weeks. I know everyone heals differently and I am hoping to be one of the lucky people that won't need any walking aids!
  • I had a 360 fusion of L4/L5. The most comfortable position for me was lying on my back. I went back to work in 3 weeks. I have always been active and was very lucky to have always done my core strengthening exercises. I was back swimming in 3-4 weeks and back on my bicycle soon after (my upright commute bike, took a little longer to get back on the road bike). I was walking a lot after my surgery. I have another fusion 7 months later (this time L1 to L5) so I had just started healing. It was several years before I felt really recovered. And as soon as I was feeling really recovered I had ANOTHER fusion, this time L5/S1. This one is a longer recovery than any of the others but a little different procedure too. Everyone is different but walking and moving for me has been the best thing for recovery. Good luck!!


    Spinal stenosis, spondolysis, spondolythesis, L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion with instrumentation and bone graft from hip, L1/S1 fusion with replacement disc put in, PT, accupuncture, prolotherapy, many cortisone injections, 4 rhizotomies. Currently on tramadol
    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • After surgery my muscles were pissed off and sore. I used ice packs after surgery. I bought the flat clay-like ones that you leave in the freezer, they are nice and flat. I was in great shape before surgery, very active. Now i am not and have gained a lot of weight.

    I was kinda' in a position like yours. I was desperate to do anything to get my life back. Plus, that white lite sharp pain will make you receptive to anything.

    I use the heating pad now as I am very stiff when I get up and after working. I have a list of things wrong with my back, and there is no magic bullet. I was told before my surgery that my pain may improve, but that was not the reason for surgery.

    I have to walk continuously at work. i have to cross the assembly lines numerous times on crappy little stairs. Because I had lost feeling in my left leg, I was afraid of falling. Walking had become quite mental, as you take for granted how much coordination just walking requires. When you can feel you legs you brain just does those calculations unconsciously.

    Just make sure you know what the risks are, and what your surgeon can reasonably assure as an outcome. You need to be aware that pain relief may not be likely. That is a big surgery, no matter what anybody tells you. If you have a good surgeon he will be able to tell you these things, honestly, without concern. I am so glad to be walking now without the fear of falling. I guess getting used to the pain and your new reallity is another matter. I used the best surgeon in the area, and he was honest and performed a great surgery for me. In fact, after I saw what my insurance paid him and the vascular surgeon to stand hunched over me for 9 hours straight, I don't think it was about the money for them.

    In addition to the surgeon I have seen a pain psychologist and have a wonderful pain management doctor. The pain management doctor is the only one I see anymore.

    good luck
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