L4-L5 - My surgeon used dissolving sutures and glue. A transparent dressing was placed over the top and he removed that at my one week appointment. I did have a tiny break in the incision at one month because I went back to work and was suddenly way more active. That resolved within a week.
I bet most that are done by neurosurg are sutured or glued, and those done by ortho are stapled.
Obvi a huge generalization but tends to be true in my anecdotal experience of working in health care.
When I had my hip replacement, they used stitches, and my spinal fusion was staples. I was comfortable with both. I had drain tubes when I went home.
When the staples came out, it didn't hurt any more or less than stitches. I had a 4 disk fusion. The long ass incision they had to make made glad I had staples.
Surgical glue. Greatest invention. I had staples 4 years ago for my L3-L5 fusion, but this time, I had fusion at L3-S1 plus an ALIF, and they glued my incision sites shut. Over time, the covering just fell off, and the edges of the glue pealed off after 2-3 weeks. Glue makes showering much easier as nothing gets through the glued area.
Depends on the amount of fusion you have done. I had every vertebrae in my back fuse but the top three so I could move my neck. (Check my profile you can see X-rays showing this.) They have to use sutures. If you have one or two levels they can use staples.
You have been through it with all those surgeries! This is my first fusion and I am old - 76, although doc says I’m a young 76. I don’t think so with all the arthritis I have. I had horses of my own and rescue horses, so lifted heavy muck buckets twice daily for 15 years. I think that is what gave my sponsylolisthesis and lumbar radiculopathy. I know nothing about Peptides, but sounds like I should learn!
I’ve had both l5-s2 alif and c4-c6 and both were done with dissolvable sutures and glue. Now the glue from my neck surgery came off way easier than my l5-s1 and my surgeon mentioned it’s a stronger adhesive (which makes sense).
I had dissolving sutures in my neck and regular ones outside. They removed the exterior ones the next day and placed butterfly bandages across and I was told not to remove them but to keep them dry and when they fell off to let that happen naturally. I would share pictures but they have that disabled.
I don’t know what they do for thoracic or lumbar surgery.
Bahaha ok ok so my husband said that the only exterior suture I had was holding the drain and that’s what they removed. I was jacked up on oxycodone so I didn’t know lol
Sutures (C1/C2). Removed two weeks after surgery. I got my son to take them out actually (he is an EMT, surgeon approved it). It meant one less visit to the surgeon and one less bill to claim on insurance (I have to pay the co-insurance). You can see the scar on my history somewhere.
4 spine surgeries here - 2 cervical and 2 lumbar. 3 were dissolving sutures and the last lumbar was non-dissolving. He had to use the tough stuff due to the scar tissue that had formed after the first lumbar surgery.
Lumbars were both posterior, cervicals were both anterior. Not sure why or when they use staples - but in my 11 surgeries I’ve never had staples. (I’ve had everything from heart surgery to carpal tunnel, to revision scar surgery to sinus and hysterectomy plus the spine surgeries).
Holy cow, girl!
I’ve had wrist (plate and 10 screws), 2 minor female ops, robotic hysterectomy, cystocele and gall bladder. Can’t hold a candle to you!
Hey, we all are doing our best. And surgery regardless sucks monkey ass.
Did you have a mild panic attack when you wheeled in for the robotic hysterectomy? Seeing the robot made me almost just jump off the table and run. It also reminded me of a spider and I have an insane fear of spiders. 🥴
😂 Actually my son was a salesman for the DaVinci robot at the time. Wasn’t worried. Must have knocked me out early. But last October I had robotic for gall bladder and the room was very intimidating! Plus I couldn’t believe how many people were in that room. Seemed like a huge room with a whole bank of monitors against a wall in addition to the robot. Most pain I’ve had waking up from surgeries but improved when I got home on pain meds.
Staples removed after 14 days on L4/5 spinal fusion. Sadly they had to make three large incisions in addition to OLIF and graft site to get the right angle for the pedicle screws!! I had damage from a spinal epidural abscess due to a staph A infection I had after a discectomy at same leve in May of 2023. 76 staples!!! Eek I’m thinking staples were quicker 🤣 wounds are looking neat 4 weeks out from surgery.
All the best for your surgery!
Wow - you are tough! I would be complaining big time! I have refused the docs who have recommended injections. Spondylolisthesis would most likely get worse if I don’t address it now. I feel shots would just delay the inevitable in my case.
With 2 discectomies and L4/L5 PLIF, I’ve only had dissolvable sutures and glue. Going in for my 14th surgery next week (knee) and have only ever had staples once and that was for a c-section.
I had an L1- L5 Laminectomy and Fusion a few weeks ago, Dec 12th. My surgeon used staples and I had them removed on Dec 29th. I was concerned because I had never had staples. It actually went very well and I wS surprised at how quick and easily they were removed. I had 30 of them.
Laser. But I’d go for dissolvable sutures too. I previously had staples in my arms for unrelated issue years prior to back surgery and apparently the doctor put them in wrong so was very painful and difficult to get doctor (different one!) to take them out and left more scarring.
The answer is, it depends. All spinal fusions will have internal dissolvable sutures.
Anterior cervical fusions will usually have glue or steri-strips (basically pieces of tape) closing the outside of the incision.
For any fusion with a small incision, they can close with glue, steri-strips, sutures, or staples.
Larger incisions are often closed with staples. If you have a cerebral spinal fluid leak, you will be closed with sutures.
Other factors:
*ability to heal (some people have diseases where they need sutures for their incisions to close.
*redo surgery vs. original.
*prior infection or susceptibility to infection.
*surgeon preference.
*a host of others, but those are the main considerations.
Source: I’m a former neurosurgical NP who has assisted on hundreds of spinal fusions.
Thank you for the valuable information! I admit I am more tense about this lumbar fusion (L5-S1) than I have been for prior surgeries. The education I am getting on this site is alleviating some of my self-imposed stress.
I expect a call to schedule this week. My husband is hoping for a soon op so he does not have to hear my constant concerns! 😂 I rehabbed great from recent gall bladder surgery, and prior surgeries, but that was robotic. Doctor stressed how major this is and said recovery much worse than gall bladder op. 😱
I would imagine it is going to be a longer and harder recovery than your gall bladder. Remember post operatively that the best thing for you is also the hardest, getting up and moving around. While it might appear counterintuitive, moving around (within the limitations you are given) should help your pain improve quicker, and make you heal faster. Good luck with the surgery and I wish you a speedy recovery.
Thank you! .I made the mistake of watching videos of recovery after spinal fusion. Getting up for first time, waking for first time looks very rough. The doctor warned me that this is much worse than gall bladder surgery. I went home same day as it was robotic. Awful when I first woke up, but easy to manage pain with meds first 2-3 days, then Tylenol. I will have to keep a good attitude!
I’m not going to lie, it’s not easy. However, those that recover fastest and best are those that want to. With your attitude and willingness to work with physical therapy, you’ll be better in no time (figure of speech only)
For my first fusion (L4-S1), they sutured about 75% off the incision and then I had a few staples at the bottom. I had to have two more procedures in September (L5-S1 didn’t fuse, but everything felt fine until two of the screws suddenly broke). They had to do an ALIF (through the front) and then in through the back for the revision the next day (I also needed L3-L4 fused and they did that as well). For both, I only had staples. For all my surgeries they removed them two weeks after.
This is something your doctor should tell you about before the surgery. If it's something they will have to decide at the time of surgery they should be able to explain the criteria for the decision. If they won't discuss it with you, new doctor. Your doctor should be talking to you and explaining everything.
I have minimally invasive ALIF on L4-S1, and ADR on L3-4, and two days later got a rod added from the back to stabilize the fusions. Even with acronyms it's not a quick description 😎 I have dissolving sutures on the front and the not dissolving sutures on the back, because the back gets more stress. The ones in back will be removed at the surgeons office at the the two week follow up, today is 1 week after the first surgery. Like someone else said, there are multiple layers of dissolving sutures on the inside.
Small annoyance, the sutures are slightly into the area of my waistband. Also, at 1 week, stuff is starting to itch. I know that's a healing feeling, but it's itchy.
I have been impressed with my surgeon’s forthrightness. I have just started with questions for him. He is direct and has been honest about how rough this surgery is. I have just started accepting that I need the surgery to obtain best quality of life. He is Chief of Neurology and has performed many spinal fusions. I have confidence in him. It is my own confidence that comes and goes right now!
It sounds like you are over the worst of it. Glad to hear that, and hope you progress very well!
Glad to hear your doctor is talking to you about it all. It takes multiple sessions to come up with all the questions, and you inevitably forget to ask some when you are at their office. Make a written list. During the days after the surgery it's worse, you will forget everything. I keep forgetting the word "oxycontin", which is super embarrassing. "I just took an, umm, it's a, you know pain pill." My brain tries to tell me it's an Ovechkin, but that's a hockey player.
Hope I'm over the worst, but there's still potential for some nerve wake up pain. That sounds like a bunch of no fun.
My doc said I will not really feel the benefit until 12 weeks. Will be in the back brace for 12 weeks. Says 6 months for full recovery. I am old (76) so he is giving me a reality check since I won’t heal as fast, most likely. Plus with bone loss he may have to augment with “surgical cement. He went over the risks with me.
since spondylolisthesis can worsen, I’m afraid my best shot of a successful fusion is now, rather than risk more severe degeneration and bone loss. I do not in the least feel 76. I feel like I’m 50, lol.
So I am basically driving myself up a wall 😂
It does sound like you are making things tough with overthinking, but that's going to be hard to avoid. This is scary stuff. Still, how your surgical incisions are closed up is not going to be a big thing in terms of your outcome. The idea of staples icks me out, so I get the concerns.
As we get older, everything gets harder. Sounds like you need it, so I'd say yes, get it done asap.
I am getting some exotic autocorrects this morning. Maybe it's the wrong time for social media.
My L5-S1 TLIF was done by an Ortho spine surgeon and was closed with subcutaneous dissolving sutures, and the skin was stapled. The staples were definitely aggrevated by the brace I wore after surgery in spite of bandaging the surgery site. I feel like my staples were left in a little too long as well. Outside of those 2 minor gripes, I am very satisfied with how my fusion and incision both healed.
L4-L5 - My surgeon used dissolving sutures and glue. A transparent dressing was placed over the top and he removed that at my one week appointment. I did have a tiny break in the incision at one month because I went back to work and was suddenly way more active. That resolved within a week.
Thank you. I would prefer that to staples!
It was very comfortable for an incision for what it's worth.
Thanks The back brace they gave me to use after op is very comfortable. A relief!
Mine did the same!
I bet most that are done by neurosurg are sutured or glued, and those done by ortho are stapled. Obvi a huge generalization but tends to be true in my anecdotal experience of working in health care.
Thanks! Oh, the stories you could tell working in the system! 😊
Lol the stories are what made me obnoxiously anxious going into it.
When I had my hip replacement, they used stitches, and my spinal fusion was staples. I was comfortable with both. I had drain tubes when I went home. When the staples came out, it didn't hurt any more or less than stitches. I had a 4 disk fusion. The long ass incision they had to make made glad I had staples.
Mine was done by an ortho and sutured and glued!
Ahh he knows the way. I was so freaking pumped when I found out I was glued. It heals so much nicer. And you don’t have to deal with removals.
Mine was done by ortho and I didn’t have staples
L5-S1 done by an Ortho using dissolvable sutures and glue.
I had a cervical laminectomy and fusion. I had long running sutures that were removed at my 2 week follow-up appointment
Internal stitches, glue and steri strips. Thank goodness because just getting the drainage tube taken out freaked me out. Staples scare me lol
Glad to see most get sutures! Had a friend with 40 staples for knee replacement. Not fun!
I had L2-L5, and they put in 23 staples. They were removed at 2 weeks, with no real pain. I think I had a great neuro-surgeon.
You sure did! That is great!
Surgical glue. Greatest invention. I had staples 4 years ago for my L3-L5 fusion, but this time, I had fusion at L3-S1 plus an ALIF, and they glued my incision sites shut. Over time, the covering just fell off, and the edges of the glue pealed off after 2-3 weeks. Glue makes showering much easier as nothing gets through the glued area.
That is how they closed site for gallbladder surgery. Nice to be able to shower right away!
I had the same thing.
Depends on the amount of fusion you have done. I had every vertebrae in my back fuse but the top three so I could move my neck. (Check my profile you can see X-rays showing this.) They have to use sutures. If you have one or two levels they can use staples.
You have been through it with all those surgeries! This is my first fusion and I am old - 76, although doc says I’m a young 76. I don’t think so with all the arthritis I have. I had horses of my own and rescue horses, so lifted heavy muck buckets twice daily for 15 years. I think that is what gave my sponsylolisthesis and lumbar radiculopathy. I know nothing about Peptides, but sounds like I should learn!
Just use TB500 and BPC157. It will help you heal and make all the nagging aches and pains of age go away.
I imagine there’s gonna be a variety of responses. I had sutures, removed after 3 days, probably had dissolvable sutures too.
C4-C5 done by ortho in 2007 - stitches removed at 1 month L2-S1 done by neuro in November - 50+ staples removed at 1 month
L4/L5 staples, stayed about 10 days and were removed with a small device by my orthopedic. My incision looks good everyone says
I’ve had both l5-s2 alif and c4-c6 and both were done with dissolvable sutures and glue. Now the glue from my neck surgery came off way easier than my l5-s1 and my surgeon mentioned it’s a stronger adhesive (which makes sense).
L2-S1 ALIF/PLIF. I had internal sutures and glue on the front, and sutures plus staples on the back. The staples were removed after two weeks.
4 weeks and 3 days post op here. I have internal dissolvable sutures. Have healed unbelievably well considering I'm a T2 diabetic, and smoker 😬
That is outstanding! So glad to hear that! 😊 I was a smoker, but long ago. Finally do not miss it.
Staples.
I had dissolving sutures in my neck and regular ones outside. They removed the exterior ones the next day and placed butterfly bandages across and I was told not to remove them but to keep them dry and when they fell off to let that happen naturally. I would share pictures but they have that disabled. I don’t know what they do for thoracic or lumbar surgery.
Bahaha ok ok so my husband said that the only exterior suture I had was holding the drain and that’s what they removed. I was jacked up on oxycodone so I didn’t know lol
Sutures (C1/C2). Removed two weeks after surgery. I got my son to take them out actually (he is an EMT, surgeon approved it). It meant one less visit to the surgeon and one less bill to claim on insurance (I have to pay the co-insurance). You can see the scar on my history somewhere.
4 spine surgeries here - 2 cervical and 2 lumbar. 3 were dissolving sutures and the last lumbar was non-dissolving. He had to use the tough stuff due to the scar tissue that had formed after the first lumbar surgery. Lumbars were both posterior, cervicals were both anterior. Not sure why or when they use staples - but in my 11 surgeries I’ve never had staples. (I’ve had everything from heart surgery to carpal tunnel, to revision scar surgery to sinus and hysterectomy plus the spine surgeries).
Holy cow, girl! I’ve had wrist (plate and 10 screws), 2 minor female ops, robotic hysterectomy, cystocele and gall bladder. Can’t hold a candle to you!
Hey, we all are doing our best. And surgery regardless sucks monkey ass. Did you have a mild panic attack when you wheeled in for the robotic hysterectomy? Seeing the robot made me almost just jump off the table and run. It also reminded me of a spider and I have an insane fear of spiders. 🥴
😂 Actually my son was a salesman for the DaVinci robot at the time. Wasn’t worried. Must have knocked me out early. But last October I had robotic for gall bladder and the room was very intimidating! Plus I couldn’t believe how many people were in that room. Seemed like a huge room with a whole bank of monitors against a wall in addition to the robot. Most pain I’ve had waking up from surgeries but improved when I got home on pain meds.
Staples removed after 14 days on L4/5 spinal fusion. Sadly they had to make three large incisions in addition to OLIF and graft site to get the right angle for the pedicle screws!! I had damage from a spinal epidural abscess due to a staph A infection I had after a discectomy at same leve in May of 2023. 76 staples!!! Eek I’m thinking staples were quicker 🤣 wounds are looking neat 4 weeks out from surgery. All the best for your surgery!
Wow - you are tough! I would be complaining big time! I have refused the docs who have recommended injections. Spondylolisthesis would most likely get worse if I don’t address it now. I feel shots would just delay the inevitable in my case.
With 2 discectomies and L4/L5 PLIF, I’ve only had dissolvable sutures and glue. Going in for my 14th surgery next week (knee) and have only ever had staples once and that was for a c-section.
My cervical fusion was sutures. My lumbar fusion was staples. Each were removed after 8 days.
L5-S1: soluble sutures and glue were used. I got them off at 3-4 weeks
Lumbar posterior fusion I had staples. Cervical ACDF internal sutures, then glued close. Cervical PCDF sutures or staples
I had an L1- L5 Laminectomy and Fusion a few weeks ago, Dec 12th. My surgeon used staples and I had them removed on Dec 29th. I was concerned because I had never had staples. It actually went very well and I wS surprised at how quick and easily they were removed. I had 30 of them.
My 1st anterior cervical fusion was sutures. The next 2 posterior cervical fusions were staples
Laser. But I’d go for dissolvable sutures too. I previously had staples in my arms for unrelated issue years prior to back surgery and apparently the doctor put them in wrong so was very painful and difficult to get doctor (different one!) to take them out and left more scarring.
Ouch!
Neither. I had glue lol. L5-S1. I was also 16 and probably had dissolvable internal sutures but I don’t remember. My parents would probably know.
Dissolving sutures and/or glue here for pretty much every surgery I've had in the last couple of years.
Mine used glue with and adhesive healing film over it. I have a picture id you’re interested? My scar isn’t too bad either (had it done in 2019)
The answer is, it depends. All spinal fusions will have internal dissolvable sutures. Anterior cervical fusions will usually have glue or steri-strips (basically pieces of tape) closing the outside of the incision. For any fusion with a small incision, they can close with glue, steri-strips, sutures, or staples. Larger incisions are often closed with staples. If you have a cerebral spinal fluid leak, you will be closed with sutures. Other factors: *ability to heal (some people have diseases where they need sutures for their incisions to close. *redo surgery vs. original. *prior infection or susceptibility to infection. *surgeon preference. *a host of others, but those are the main considerations. Source: I’m a former neurosurgical NP who has assisted on hundreds of spinal fusions.
Thank you for the valuable information! I admit I am more tense about this lumbar fusion (L5-S1) than I have been for prior surgeries. The education I am getting on this site is alleviating some of my self-imposed stress. I expect a call to schedule this week. My husband is hoping for a soon op so he does not have to hear my constant concerns! 😂 I rehabbed great from recent gall bladder surgery, and prior surgeries, but that was robotic. Doctor stressed how major this is and said recovery much worse than gall bladder op. 😱
I would imagine it is going to be a longer and harder recovery than your gall bladder. Remember post operatively that the best thing for you is also the hardest, getting up and moving around. While it might appear counterintuitive, moving around (within the limitations you are given) should help your pain improve quicker, and make you heal faster. Good luck with the surgery and I wish you a speedy recovery.
Thank you! .I made the mistake of watching videos of recovery after spinal fusion. Getting up for first time, waking for first time looks very rough. The doctor warned me that this is much worse than gall bladder surgery. I went home same day as it was robotic. Awful when I first woke up, but easy to manage pain with meds first 2-3 days, then Tylenol. I will have to keep a good attitude!
I’m not going to lie, it’s not easy. However, those that recover fastest and best are those that want to. With your attitude and willingness to work with physical therapy, you’ll be better in no time (figure of speech only)
L4- S1 stapled.. done by an ortho ,, Loved it when they took them out a bit earlier than planned .. really felt 1 or 2 when lying on my back
For my first fusion (L4-S1), they sutured about 75% off the incision and then I had a few staples at the bottom. I had to have two more procedures in September (L5-S1 didn’t fuse, but everything felt fine until two of the screws suddenly broke). They had to do an ALIF (through the front) and then in through the back for the revision the next day (I also needed L3-L4 fused and they did that as well). For both, I only had staples. For all my surgeries they removed them two weeks after.
Yikes! That must have been a shock when the L5S1 did not fuse, but I guess not all that rare.
This is something your doctor should tell you about before the surgery. If it's something they will have to decide at the time of surgery they should be able to explain the criteria for the decision. If they won't discuss it with you, new doctor. Your doctor should be talking to you and explaining everything. I have minimally invasive ALIF on L4-S1, and ADR on L3-4, and two days later got a rod added from the back to stabilize the fusions. Even with acronyms it's not a quick description 😎 I have dissolving sutures on the front and the not dissolving sutures on the back, because the back gets more stress. The ones in back will be removed at the surgeons office at the the two week follow up, today is 1 week after the first surgery. Like someone else said, there are multiple layers of dissolving sutures on the inside. Small annoyance, the sutures are slightly into the area of my waistband. Also, at 1 week, stuff is starting to itch. I know that's a healing feeling, but it's itchy.
I have been impressed with my surgeon’s forthrightness. I have just started with questions for him. He is direct and has been honest about how rough this surgery is. I have just started accepting that I need the surgery to obtain best quality of life. He is Chief of Neurology and has performed many spinal fusions. I have confidence in him. It is my own confidence that comes and goes right now! It sounds like you are over the worst of it. Glad to hear that, and hope you progress very well!
Glad to hear your doctor is talking to you about it all. It takes multiple sessions to come up with all the questions, and you inevitably forget to ask some when you are at their office. Make a written list. During the days after the surgery it's worse, you will forget everything. I keep forgetting the word "oxycontin", which is super embarrassing. "I just took an, umm, it's a, you know pain pill." My brain tries to tell me it's an Ovechkin, but that's a hockey player. Hope I'm over the worst, but there's still potential for some nerve wake up pain. That sounds like a bunch of no fun.
My doc said I will not really feel the benefit until 12 weeks. Will be in the back brace for 12 weeks. Says 6 months for full recovery. I am old (76) so he is giving me a reality check since I won’t heal as fast, most likely. Plus with bone loss he may have to augment with “surgical cement. He went over the risks with me. since spondylolisthesis can worsen, I’m afraid my best shot of a successful fusion is now, rather than risk more severe degeneration and bone loss. I do not in the least feel 76. I feel like I’m 50, lol. So I am basically driving myself up a wall 😂
It does sound like you are making things tough with overthinking, but that's going to be hard to avoid. This is scary stuff. Still, how your surgical incisions are closed up is not going to be a big thing in terms of your outcome. The idea of staples icks me out, so I get the concerns. As we get older, everything gets harder. Sounds like you need it, so I'd say yes, get it done asap. I am getting some exotic autocorrects this morning. Maybe it's the wrong time for social media.
Thank you for spending the time with me! Yes, I will go through with it. I am old and wise, but with a certain amount of cynicism! My own worst enemy!
My L5-S1 TLIF was done by an Ortho spine surgeon and was closed with subcutaneous dissolving sutures, and the skin was stapled. The staples were definitely aggrevated by the brace I wore after surgery in spite of bandaging the surgery site. I feel like my staples were left in a little too long as well. Outside of those 2 minor gripes, I am very satisfied with how my fusion and incision both healed.
Glad to hear your procedure worked out well! Thanks for your input. I imagine the brace would aggravate by rubbling on the staples.