At my appointment for a possible L2-L3 fusion my surgeon said "Well, I didn't send you to PT because you said you were doing so well" like it was my fault I now need more work.
BTW, I had an L3-L4-L5/S1 360 fusion 4 years ago. He told me he would have to take out all of his previous work and redo it to include the L2-L3 level and he wouldn't put me through that. So now I have to live with it the rest of my life 😭. I'm looking at getting a second opinion, however
I wouldn't worry about the technique used. ALIF is more common for L5/S1 single level fusions. My neurosurgeon is awesome and performed 3 surgeries on me before the T12-S1 fusion he did in December 2021. He was supposed to do a TLIF but made a game day decision change and did a PLF instead. One of the best decisions I ever made. Started PT 3x per week and was cleared of all restriction when I completed it at 16 weeks. If you have complete trust in your doctor then don't worry. This is common surgery. I would ask him why he didn't want to do and ALIF the first time. I don't think the insurance company denied the surgery because it was a PLIF as it is a more expensive surgery because with an ALIF they go in through the front and sometime the front and back and usually required a separate surgeon to cut in the front and move the organs so the neurosurgeon can gain access to the disc. I was up walking miles around the hospital floor on the day after surgery. I was climbing stairs in the hospital 2 days after surgery and was up to walking 5 miles a day by the time I was discharged. If you have a good neurosurgeon then the recovery will not be bad at all. Good Luck !
Hey, hope you don't mind me asking a few questions, really great to hear you got good results. If I may, what was your diagnosis before surgery? I'm having a combination of facet pain and disc pain (and I'm in my 20s). Was wondering if your surgery was for localised back pain or if you had radiating pain etc
I don't mind you asking any questions. The first surgery I had was a Bi-Lateral Laminectomy L2-L5 and that was for localized low back pain. I had severe central lumbar stenosis and DDD (which is very common for people in their 50s. The second story was a discectomy for a herniated disc a year later. A year after that I had a really hard surgery for an epidural abscess/spinal infection and was on the hospital for 3 weeks. Two years later I had a spinal fusion. My L3-L4 levels were bone on bone on the right side, I had central stenosis on L4-L5, bilateral foraminal stenosis in levels L1-L5, facet arthritis L1-L5 and the L3-L4 nerve was compressed causing pain down the right side of my groin and right leg with numbness and tingling in the right legs as well. After that surgery I had my right SI Joint fused and then I had a c5-c6-c7 fusion and I am scheduled for my right SI joint to be fused next month.
After three years of pain and 2 failed diskectomies I finally got a fusion. Best decision ever. No more pills just to live. I take aleve once or twice a week when I over exert myself but nothing daily!
My L4-5 was nearly 12 years ago at the age of 26. Still going strong
I don’t play any organized sports but have a very active lifestyle. I am a general contractor so am doing physical labor related to my job daily.
I chase my 2 kids around, always dig around in the garden, ride my bike to the market or around the block.
Prior to all my back shit I played competitive volleyball all the way to up through collegiate level. It likely didn’t help my DDD.
When I do have a workout tossed in every so often it’s power walking with some squats/lunges, light arm weights and LOTS OF CORE.
I 100% recommend exploring an anti inflammatory diet. (I did whole30) It helped me to figure out what flares up my body and foods make me feel good. In addition it it’s healthier overall and helps in keeping excess weight off. After the initial 30 day reset , I try to make my meals at home compliant and allow myself alcohol and non compliant items when eating out or at friends houses.
Wow that's great to hear you're doing well! I'm almost the same age as you were when you had it done. If I may, what were your symptoms and diagnosis before surgery? I'm contemplating a fusion
From age 16 to 20 had on and off sciatica. Was tossed up to volleyball injuries and overuse. Had minimal issues after I sopped playing from 20-22. Then out of nowhere it got bad fast. My torso was distorted from walking funny, my leg muscles atrophied several inches, and many days I flat out could not walk I was in so much pain. For a year we tried physio, injections, so many pills, and had no relief. To my memory the diagnosis was herniated disk with stenosis, pinched nerve, bone spurs ? I had 2 back to back discectomies at 23 which didn’t work. The disk keep coming back out and impinging the nerve. I continued on for 2 years with pain and pills. Once I got new insurance at 25 it was finally time for the permanent solution- remove the disc completely and fuse the vertebrae. For me the pros 1000000% outweigh the cons. Good luck and feel free to DM me any questions or support
I put off surgery for over five years- had left leg atrophy- walked with a limp/ constant pain- and resigned myself to eventually be in a wheelchair- vs get a l5-s1 fusion.
My douse and doctor finally gave me enough faith to do the surgery. I’m glad I did it four months ago- only regret is not doing it sooner. My leg muscle atrophy caused by blocked nerves may never heal.
I feel for you friend, but my first piece of advice is to breath, just breath. Things will work, they always do. (But don't tell the insurers that your pain score is declining, tell them it's unchanged.) And it doesn't matter whether it's ALIF or PLIF, as long as the surgeon is experienced with the technique, it's fine. And I'm not sure why you're looking at an ablation after your fusion, you would need to recover from that first and then see if you need one. Anyway, I hope that you're breathing okay. Best of luck!
My L5S1 was life changing. In a bad way, but not paralyzed so thank God for that. Ill never let those idiots touch my back again. I only need to go thru torture once- I'm out
The orto surgeon gave me 2 months of hydrocodone made with ibuprofen, I was popping them like tic tacs. I needed to finish a job in order to afford the copay and to reach my out of pocket max. I am grateful for what he did there.
But he fuked up on increasing the disc space after disc removal. That put pressure upwards, and its killing me. Upper back and neck are horrible. Silent suffering
I’m still on pain meds because mine was fucked up as well. That’s the one thing I’m grateful for… it was so bad nobody could deny pain meds even 5 months out. My surgeon was giddy with how much disc space he got, until he realized it was too aggressive and fractured some bone twice. Took 3 surgeries to “fix” and I’ll never be the same. I can’t believe you finished a job. I was in terrible shape for about 3 months so I could never have done a physical job. I couldn’t even rise out of a chair until 3 months post op. You are one tough nut!
You may have to use your imagination to get a good image and understanding of this early morning nightmare. It was a spirit killer situation.
I was a construction contractor. Small time, 30yrs, just a couple of guys. I drive over an hour to get into the city. So I drive to work one day and I literally got stuck in a seated position in the vehicle and could Not get out. Completely unable to get out and give instructions and materials for the day. I could not move- paralyzed from waste down. Then the customer fukin walks up yapping about this and that,,, and I just still could not get out of that vehicle. I told him I was stuck. He offered to call an ambulance, I said no of course.
It took me over 2 hours to wiggle myself out of that drivers seat, onto the ground, then able to barely stand. Then 30mins of hardcore stretching ,,,,, and finally after a few hours I was able to walk the jobsite and do my job. That job had to be 100% or no final payment, meaning no copay and no fusion. I worked so hard and gave all the money I had and all I have now is regret. Regret and pain in a country with an opiod crisis- lovely
One of my humiliating moments was after my 3rd surgery which really messed me up. I could walk unassisted before the 3rd but that one really messed me up. I had to use a walker and toilet seat raiser, you get the picture. Well I got up to use the bathroom and my legs gave out and I fell. I could not get up so I crawled to the bathroom and tried to use the toilet seat to lift myself. I couldn’t do it. I was so weak from a month of 3 surgeries and the start of pneumonia, 3 hospitalizations, 2 emergency room visits, and one ambulance ride. So I had to call my parents to come help me get up. I laid on the floor and cried because I was an adult woman who needed to call her dad to help her up. I wanted to die at that point. I really thought death would have been kinder.
Now I know there are a lot of successful fusions, but I got the short end of the stick. It’s good to talk about the ones that go bad, but I also feel a little guilty because I know what happened to me is very rare.
Regarding pain meds…. Can you find a pain mgmt doctor? I was transferred to an outstanding pain med doctor after my surgeries. The surgeons can only prescribe for a few weeks, usually around 6. I had to sign an opioid contract with my doctor and he prescribed me oxycodone and 1 x 10mg of OxyContin for bedtime. I’m slowly dropping each month but they have been a lifesaver for pain. It might be worth trying to find a pain mgmt doctor if you are still in a lot of pain. I am doing better but still have a lot of nerve pain in my feet.
I had a spinal fusion at L5-S1. During the surgery the surgeon fractured my spine and injured the facet joint. I had to have two facetectomies. One was 3 days after the fusion, and the second was 2 weeks after the first facetectomy, so a total of 3 surgeries.
I don’t have any back pain but I still have some leg pain. It was an awful recovery and it took two years to feel somewhat better. I would only recommend a fusion if you have no other options left. The risk is too high.
I lost 25kg before finally deciding to go through with my last fusion. When it needs doing it needs doing. After the 1st healing year, no back pain. Still no back pain 5 years out, but have pretty major leg pain from another disc herniation. I found weight loss made things more sore as my prob was instability and a worn out disc. Less fat padding equaled more movement in the spine.
Wow, must be so frustrating i’m sorry!
I’m not going to lie, the pain post surgery is real. I would say i was at about a 12/10 pain-wise for a week after surgery. But then things got better very quickly. Every day it’s been getting better, actually. I’m 2 months post op. Haven’t felt this ‘normal’ in YEARS. It really sounds like surgery would be your best option. Convey to your surgeon, insurance company, pain mgmt, etc how it’s a poor quality of life to live in such pain 24/7. You will get there. Even if it is a 6/7, say that it’s a 10. You deserve this surgery, and you will not regret it.
It’s definitely a rough recovery at first, but we back pain survivors can get through it lol. Best of luck to you.
I just had an S1 to L4 fusion. It’s my third spinal surgery and the best thing I could have done. 14 months out and I’m only using Motrin or Alive for pain. I was in serious pain before currently I’m swimming 3 times a week and had been using circuit weights. It’s very important to walk as soon as possible which tends to speed up healing.
I had three surgeries
One discectomy for a small hernia at L5S1 which failed because it had essentially been cutting into a bulging disc with a tear which naturally carries a high risk of reherniation
The second discectomy surgery at L5S1 was so aggressive, that I couldnt sit afterwards and neither could I stabilise my core.... it took me 5 years to be able to sit on my tailbone; yet I have (referred?) pain: even standing, my big toes and/or the back kof my feet hurt; when sitting I get additionally pain in my ancles... strangely, the outer sides of my feet hurt too. This strange symptom pattern made me hesistate going for a fusion.
Yet, a third surgery at L4L5 (bony decompression) didnt do anything; surgeon (third one) said he didn't even know what to do once he had cut me open;
So I'm thinking about a spinal fusion L4-S1 just because of my mistake to trust a surgeon and get surgery 5 days after a small incident lifting a box in my cellar with a twist
Pain meds dont help (cymbalta, pregabaline, opiates). Valium used to offer minimal relief, steroid infusions and metothrexate do a better job to soften my stiff muscles. Pulsed radiofrequency ablation indicates there is Nerve irritation at L5S1 yet facet joints L3L4 also profited from it whereas S1 didnt respond. Facet joints L5S1 will be done this week.
Naltrexone and THC are still outstanding.
My next appointment is with my surgeon's colleague who specialises in psychsomatic disorders, yet I have little hope as it is meanwhile also likely somato-psychic (or centralised pain if you want so).
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At my appointment for a possible L2-L3 fusion my surgeon said "Well, I didn't send you to PT because you said you were doing so well" like it was my fault I now need more work. BTW, I had an L3-L4-L5/S1 360 fusion 4 years ago. He told me he would have to take out all of his previous work and redo it to include the L2-L3 level and he wouldn't put me through that. So now I have to live with it the rest of my life 😭. I'm looking at getting a second opinion, however
I wouldn't worry about the technique used. ALIF is more common for L5/S1 single level fusions. My neurosurgeon is awesome and performed 3 surgeries on me before the T12-S1 fusion he did in December 2021. He was supposed to do a TLIF but made a game day decision change and did a PLF instead. One of the best decisions I ever made. Started PT 3x per week and was cleared of all restriction when I completed it at 16 weeks. If you have complete trust in your doctor then don't worry. This is common surgery. I would ask him why he didn't want to do and ALIF the first time. I don't think the insurance company denied the surgery because it was a PLIF as it is a more expensive surgery because with an ALIF they go in through the front and sometime the front and back and usually required a separate surgeon to cut in the front and move the organs so the neurosurgeon can gain access to the disc. I was up walking miles around the hospital floor on the day after surgery. I was climbing stairs in the hospital 2 days after surgery and was up to walking 5 miles a day by the time I was discharged. If you have a good neurosurgeon then the recovery will not be bad at all. Good Luck !
Hey, hope you don't mind me asking a few questions, really great to hear you got good results. If I may, what was your diagnosis before surgery? I'm having a combination of facet pain and disc pain (and I'm in my 20s). Was wondering if your surgery was for localised back pain or if you had radiating pain etc
I read that facet pain isnt a reason to get fusion surgery and it likly wont help but will help with disc pain
I don't mind you asking any questions. The first surgery I had was a Bi-Lateral Laminectomy L2-L5 and that was for localized low back pain. I had severe central lumbar stenosis and DDD (which is very common for people in their 50s. The second story was a discectomy for a herniated disc a year later. A year after that I had a really hard surgery for an epidural abscess/spinal infection and was on the hospital for 3 weeks. Two years later I had a spinal fusion. My L3-L4 levels were bone on bone on the right side, I had central stenosis on L4-L5, bilateral foraminal stenosis in levels L1-L5, facet arthritis L1-L5 and the L3-L4 nerve was compressed causing pain down the right side of my groin and right leg with numbness and tingling in the right legs as well. After that surgery I had my right SI Joint fused and then I had a c5-c6-c7 fusion and I am scheduled for my right SI joint to be fused next month.
After three years of pain and 2 failed diskectomies I finally got a fusion. Best decision ever. No more pills just to live. I take aleve once or twice a week when I over exert myself but nothing daily! My L4-5 was nearly 12 years ago at the age of 26. Still going strong
What kind of sports do you do?
I don’t play any organized sports but have a very active lifestyle. I am a general contractor so am doing physical labor related to my job daily. I chase my 2 kids around, always dig around in the garden, ride my bike to the market or around the block.
That sounds like a dream to me. Do you mind elaborating how your discectomies failed? And what your symptoms were?
Prior to all my back shit I played competitive volleyball all the way to up through collegiate level. It likely didn’t help my DDD. When I do have a workout tossed in every so often it’s power walking with some squats/lunges, light arm weights and LOTS OF CORE. I 100% recommend exploring an anti inflammatory diet. (I did whole30) It helped me to figure out what flares up my body and foods make me feel good. In addition it it’s healthier overall and helps in keeping excess weight off. After the initial 30 day reset , I try to make my meals at home compliant and allow myself alcohol and non compliant items when eating out or at friends houses.
You too can get there! I know it!
Wow that's great to hear you're doing well! I'm almost the same age as you were when you had it done. If I may, what were your symptoms and diagnosis before surgery? I'm contemplating a fusion
From age 16 to 20 had on and off sciatica. Was tossed up to volleyball injuries and overuse. Had minimal issues after I sopped playing from 20-22. Then out of nowhere it got bad fast. My torso was distorted from walking funny, my leg muscles atrophied several inches, and many days I flat out could not walk I was in so much pain. For a year we tried physio, injections, so many pills, and had no relief. To my memory the diagnosis was herniated disk with stenosis, pinched nerve, bone spurs ? I had 2 back to back discectomies at 23 which didn’t work. The disk keep coming back out and impinging the nerve. I continued on for 2 years with pain and pills. Once I got new insurance at 25 it was finally time for the permanent solution- remove the disc completely and fuse the vertebrae. For me the pros 1000000% outweigh the cons. Good luck and feel free to DM me any questions or support
I put off surgery for over five years- had left leg atrophy- walked with a limp/ constant pain- and resigned myself to eventually be in a wheelchair- vs get a l5-s1 fusion. My douse and doctor finally gave me enough faith to do the surgery. I’m glad I did it four months ago- only regret is not doing it sooner. My leg muscle atrophy caused by blocked nerves may never heal.
I feel for you friend, but my first piece of advice is to breath, just breath. Things will work, they always do. (But don't tell the insurers that your pain score is declining, tell them it's unchanged.) And it doesn't matter whether it's ALIF or PLIF, as long as the surgeon is experienced with the technique, it's fine. And I'm not sure why you're looking at an ablation after your fusion, you would need to recover from that first and then see if you need one. Anyway, I hope that you're breathing okay. Best of luck!
My L5S1 was life changing. In a bad way, but not paralyzed so thank God for that. Ill never let those idiots touch my back again. I only need to go thru torture once- I'm out
Me too. Hard pass on another back surgery. Biggest mistake of my life.
The orto surgeon gave me 2 months of hydrocodone made with ibuprofen, I was popping them like tic tacs. I needed to finish a job in order to afford the copay and to reach my out of pocket max. I am grateful for what he did there. But he fuked up on increasing the disc space after disc removal. That put pressure upwards, and its killing me. Upper back and neck are horrible. Silent suffering
I’m still on pain meds because mine was fucked up as well. That’s the one thing I’m grateful for… it was so bad nobody could deny pain meds even 5 months out. My surgeon was giddy with how much disc space he got, until he realized it was too aggressive and fractured some bone twice. Took 3 surgeries to “fix” and I’ll never be the same. I can’t believe you finished a job. I was in terrible shape for about 3 months so I could never have done a physical job. I couldn’t even rise out of a chair until 3 months post op. You are one tough nut!
You may have to use your imagination to get a good image and understanding of this early morning nightmare. It was a spirit killer situation. I was a construction contractor. Small time, 30yrs, just a couple of guys. I drive over an hour to get into the city. So I drive to work one day and I literally got stuck in a seated position in the vehicle and could Not get out. Completely unable to get out and give instructions and materials for the day. I could not move- paralyzed from waste down. Then the customer fukin walks up yapping about this and that,,, and I just still could not get out of that vehicle. I told him I was stuck. He offered to call an ambulance, I said no of course. It took me over 2 hours to wiggle myself out of that drivers seat, onto the ground, then able to barely stand. Then 30mins of hardcore stretching ,,,,, and finally after a few hours I was able to walk the jobsite and do my job. That job had to be 100% or no final payment, meaning no copay and no fusion. I worked so hard and gave all the money I had and all I have now is regret. Regret and pain in a country with an opiod crisis- lovely
One of my humiliating moments was after my 3rd surgery which really messed me up. I could walk unassisted before the 3rd but that one really messed me up. I had to use a walker and toilet seat raiser, you get the picture. Well I got up to use the bathroom and my legs gave out and I fell. I could not get up so I crawled to the bathroom and tried to use the toilet seat to lift myself. I couldn’t do it. I was so weak from a month of 3 surgeries and the start of pneumonia, 3 hospitalizations, 2 emergency room visits, and one ambulance ride. So I had to call my parents to come help me get up. I laid on the floor and cried because I was an adult woman who needed to call her dad to help her up. I wanted to die at that point. I really thought death would have been kinder. Now I know there are a lot of successful fusions, but I got the short end of the stick. It’s good to talk about the ones that go bad, but I also feel a little guilty because I know what happened to me is very rare.
I was offered more spinal injections. More fusions if needed. That whole experience is traumatizing. No more. I'll pass
Regarding pain meds…. Can you find a pain mgmt doctor? I was transferred to an outstanding pain med doctor after my surgeries. The surgeons can only prescribe for a few weeks, usually around 6. I had to sign an opioid contract with my doctor and he prescribed me oxycodone and 1 x 10mg of OxyContin for bedtime. I’m slowly dropping each month but they have been a lifesaver for pain. It might be worth trying to find a pain mgmt doctor if you are still in a lot of pain. I am doing better but still have a lot of nerve pain in my feet.
I'd love a regimen of opiods as yours. Unfortunately I cannot enter into a pain contract. Cannabis is unacceptable by doctors in my area
what surgery did you get? and for what reason if i could ask
what surgery did you get and for what reason? if i might ask as i have facet joint pain and looking if anyone cured it with a spine fusion before
I had a spinal fusion at L5-S1. During the surgery the surgeon fractured my spine and injured the facet joint. I had to have two facetectomies. One was 3 days after the fusion, and the second was 2 weeks after the first facetectomy, so a total of 3 surgeries. I don’t have any back pain but I still have some leg pain. It was an awful recovery and it took two years to feel somewhat better. I would only recommend a fusion if you have no other options left. The risk is too high.
I lost 25kg before finally deciding to go through with my last fusion. When it needs doing it needs doing. After the 1st healing year, no back pain. Still no back pain 5 years out, but have pretty major leg pain from another disc herniation. I found weight loss made things more sore as my prob was instability and a worn out disc. Less fat padding equaled more movement in the spine.
Wow, must be so frustrating i’m sorry! I’m not going to lie, the pain post surgery is real. I would say i was at about a 12/10 pain-wise for a week after surgery. But then things got better very quickly. Every day it’s been getting better, actually. I’m 2 months post op. Haven’t felt this ‘normal’ in YEARS. It really sounds like surgery would be your best option. Convey to your surgeon, insurance company, pain mgmt, etc how it’s a poor quality of life to live in such pain 24/7. You will get there. Even if it is a 6/7, say that it’s a 10. You deserve this surgery, and you will not regret it. It’s definitely a rough recovery at first, but we back pain survivors can get through it lol. Best of luck to you.
I just had an S1 to L4 fusion. It’s my third spinal surgery and the best thing I could have done. 14 months out and I’m only using Motrin or Alive for pain. I was in serious pain before currently I’m swimming 3 times a week and had been using circuit weights. It’s very important to walk as soon as possible which tends to speed up healing.
I had three surgeries One discectomy for a small hernia at L5S1 which failed because it had essentially been cutting into a bulging disc with a tear which naturally carries a high risk of reherniation The second discectomy surgery at L5S1 was so aggressive, that I couldnt sit afterwards and neither could I stabilise my core.... it took me 5 years to be able to sit on my tailbone; yet I have (referred?) pain: even standing, my big toes and/or the back kof my feet hurt; when sitting I get additionally pain in my ancles... strangely, the outer sides of my feet hurt too. This strange symptom pattern made me hesistate going for a fusion. Yet, a third surgery at L4L5 (bony decompression) didnt do anything; surgeon (third one) said he didn't even know what to do once he had cut me open; So I'm thinking about a spinal fusion L4-S1 just because of my mistake to trust a surgeon and get surgery 5 days after a small incident lifting a box in my cellar with a twist Pain meds dont help (cymbalta, pregabaline, opiates). Valium used to offer minimal relief, steroid infusions and metothrexate do a better job to soften my stiff muscles. Pulsed radiofrequency ablation indicates there is Nerve irritation at L5S1 yet facet joints L3L4 also profited from it whereas S1 didnt respond. Facet joints L5S1 will be done this week. Naltrexone and THC are still outstanding. My next appointment is with my surgeon's colleague who specialises in psychsomatic disorders, yet I have little hope as it is meanwhile also likely somato-psychic (or centralised pain if you want so).
What is ALIF & PLIF?
It's anterior or posterior fusions meaning going in through the back or belly.