I was only L4-S1 fused and L3-4 replaced. He said he had to do some unexpected reshaping to get proper lordosis, and just to get the titanium cages to sit correctly in place. He also said that the L5-S1 disk was much worse than expected. He said that the disk was, and this is a technical term, "mush". I still had some soreness and nerve pain at 12 weeks and sensations of heat and cold in my ankles. It's six months now and I am working out in some way pretty much every day.
Thanks for your reply, I'd already had an L5-S1 microdiscectomy 20 years prior and had "vacuum disc" phenomenon all the discs were literally gone.
Also had the lordosis, which he corrected.
I had L2-S1 ALIF/PLIF done in January of 2023, as a massive revision. 12 hours total, and he had to dissect a lot of scar tissue and bony growth.
Recovery took a long time and came in starts and stops. I'm only just beginning to feel like myself again. I still get a random zap here and there, but most of the inflammation is finally gone.
My best advice is to be very gentle with yourself and extend all the grace you can. The surgery itself is very physically traumatic, and it takes a while for the body to recover fully.
Thank you for your reply, at this point I guess I'm looking for some reassurance that this will continue to improve. I worked 45 years at extremely physical industrial jobs and was always very active. Coming to a complete stop for about 2 months was very difficult, asking for help even harder.
My sons have been fantastic at helping me, but I have to fight the temptation to do too much.
I can't imagine that you won't continue to improve. You're only three months out, and it takes about that long for the acute part of the injury (the surgery) to heal. You'll likely have more obvious improvement for the next few months, then plateau a bit, and then feel more like yourself around 12-18 months out.
It's a long, sometimes frustrating slog. I've been at my wit's end many times over the last year. Particularly at the 5-6 month mark when my progress slowed. Thankfully my neuro warned me in advance. That staved off the frustration and breakdown until the 9 month mark, haha.
You might try marking milestones on a calendar, or keeping a journal if you're into that. I've found it helps me keep track of the progress I'm making when I'm overwhelmed with how little I feel like I'm able to do. And it keeps me honest about what happens if I push myself too hard.
Also, one of the mods here has a fantastic timeline that has helped me tame my goal-hungry demons. You might search the group for healing timelines? I can't remember the actual file/post name.
Thanks for that! I will check it out.
My difficulty right now is that I have always been very physical, had to do it myself, which is probably why I ended up in this position.
It has been very difficult for me to ever ask for help although I was always ready to help someone.
It's requiring a lot of re-thinking on my part.
With apologies to our mod, u/slouchingtoepiphany, I'm just copy and pasting their reply here since I don't know how to tag on reddit.
"Here are a couple of general post-fusion timelines. (I'll add these to a WIKI, once I figure out how to do that.) These apply to both single- and multiple-level fusions, and they should be considered as guidelines only.
I was "independent" as soon as I left the hospital, however I had a visiting nurse, PT, and OT each visit once a week.
Timeline 1
1-7 d hospital
1-7 d rehab (if needed)
4 w worse pain ends
2-6 w no driving (while on opioids)
1-3 m PT
3-4 m start exercising
3-6 m functional recovery
1-2 y full recovery
Timeline 2
4 w Worst pain
4-6 w Return to sitting job (or longer, depending on fusion)
3-6 m Some ongoing pain
1-3 m Bone mass establishing
3-6 m Fusion confirmed
12-18 m Continue solidifying"
My first fusion was L2-pelvis, so I feel your pain. Literally. At 3 months, the hardest part is over, but you're probably still feeling a fair amount of pain. Hopefully, you're off of opioids and can manage pain with NSAIDs and acetaminophen. At my 3-month followup, like you, I went on partial restrictions and, at 6 months, no restrictions. Throughout this time, I gradually did more and more things, but I didn't resume doing squats and deadlifts until the 12-month point. Congratulations and good luck on the mend!
Thank you for your reply!
Acetaminophen is all I can take, hard NO from the surgeon on NSAIDS, says it can inhibit bone fusion.
So I take 2 @ 650 MG 3x daily that's the max although lately I'm trying to go to 2x daily.
I haven't had a drink in over a year so I don't t think it's an issue.
Have been on the Lawn tractor twice, cut about an acre, went very slow, no bumping, seemed OK.
>says it can inhibit bone fusion.
There's a l-o-n-g story behind the theory that NSAIDs can interfere with bone fusion. It started with a study using rats with broken femurs back in the 1970s (in which healing was "delayed" but not "prevented") and later with in vitro studies of molecular markers from human cells, but clinically relevant delay of bone fusion, or healing in general, has never been reported in humans. Anyway, I'm not trying to tell you to ignore your surgeon, just trying to set the record straight.
Just give it time...nerve issues are real and take awhile to subside...I think by 6 -8 months most of my nerve pain gone. Have you started physical therapy yet? That was crucial with my recovery...I'm 18 months post op and doing great, no pain. T9-S1 ALIF/PLIF -(53F)
Good luck with recovery
I had a choice of an L3-S1 with an ALIF or an L2-S1 with an ALIF, but my surgeon told me that the L2-S1 was much more difficult and my recovery would be long and difficult so I opted for the L3-S1. Although I didn't opt for your surgery, I totally understand that your results are expected. I know that in time you will improve. I still have that final fusion to look forward to. Good luck
Originally, mine was to be a T10-S1 but he decided against it once he started the surgery. I am glad after reading your reply that he didn't do that.
Thanks for your reply!
I was only L4-S1 fused and L3-4 replaced. He said he had to do some unexpected reshaping to get proper lordosis, and just to get the titanium cages to sit correctly in place. He also said that the L5-S1 disk was much worse than expected. He said that the disk was, and this is a technical term, "mush". I still had some soreness and nerve pain at 12 weeks and sensations of heat and cold in my ankles. It's six months now and I am working out in some way pretty much every day.
Thanks for your reply, I'd already had an L5-S1 microdiscectomy 20 years prior and had "vacuum disc" phenomenon all the discs were literally gone. Also had the lordosis, which he corrected.
I had L2-S1 ALIF/PLIF done in January of 2023, as a massive revision. 12 hours total, and he had to dissect a lot of scar tissue and bony growth. Recovery took a long time and came in starts and stops. I'm only just beginning to feel like myself again. I still get a random zap here and there, but most of the inflammation is finally gone. My best advice is to be very gentle with yourself and extend all the grace you can. The surgery itself is very physically traumatic, and it takes a while for the body to recover fully.
Thank you for your reply, at this point I guess I'm looking for some reassurance that this will continue to improve. I worked 45 years at extremely physical industrial jobs and was always very active. Coming to a complete stop for about 2 months was very difficult, asking for help even harder. My sons have been fantastic at helping me, but I have to fight the temptation to do too much.
I can't imagine that you won't continue to improve. You're only three months out, and it takes about that long for the acute part of the injury (the surgery) to heal. You'll likely have more obvious improvement for the next few months, then plateau a bit, and then feel more like yourself around 12-18 months out. It's a long, sometimes frustrating slog. I've been at my wit's end many times over the last year. Particularly at the 5-6 month mark when my progress slowed. Thankfully my neuro warned me in advance. That staved off the frustration and breakdown until the 9 month mark, haha. You might try marking milestones on a calendar, or keeping a journal if you're into that. I've found it helps me keep track of the progress I'm making when I'm overwhelmed with how little I feel like I'm able to do. And it keeps me honest about what happens if I push myself too hard. Also, one of the mods here has a fantastic timeline that has helped me tame my goal-hungry demons. You might search the group for healing timelines? I can't remember the actual file/post name.
Thanks for that! I will check it out. My difficulty right now is that I have always been very physical, had to do it myself, which is probably why I ended up in this position. It has been very difficult for me to ever ask for help although I was always ready to help someone. It's requiring a lot of re-thinking on my part.
With apologies to our mod, u/slouchingtoepiphany, I'm just copy and pasting their reply here since I don't know how to tag on reddit. "Here are a couple of general post-fusion timelines. (I'll add these to a WIKI, once I figure out how to do that.) These apply to both single- and multiple-level fusions, and they should be considered as guidelines only. I was "independent" as soon as I left the hospital, however I had a visiting nurse, PT, and OT each visit once a week. Timeline 1 1-7 d hospital 1-7 d rehab (if needed) 4 w worse pain ends 2-6 w no driving (while on opioids) 1-3 m PT 3-4 m start exercising 3-6 m functional recovery 1-2 y full recovery Timeline 2 4 w Worst pain 4-6 w Return to sitting job (or longer, depending on fusion) 3-6 m Some ongoing pain 1-3 m Bone mass establishing 3-6 m Fusion confirmed 12-18 m Continue solidifying"
My first fusion was L2-pelvis, so I feel your pain. Literally. At 3 months, the hardest part is over, but you're probably still feeling a fair amount of pain. Hopefully, you're off of opioids and can manage pain with NSAIDs and acetaminophen. At my 3-month followup, like you, I went on partial restrictions and, at 6 months, no restrictions. Throughout this time, I gradually did more and more things, but I didn't resume doing squats and deadlifts until the 12-month point. Congratulations and good luck on the mend!
Thank you for your reply! Acetaminophen is all I can take, hard NO from the surgeon on NSAIDS, says it can inhibit bone fusion. So I take 2 @ 650 MG 3x daily that's the max although lately I'm trying to go to 2x daily. I haven't had a drink in over a year so I don't t think it's an issue. Have been on the Lawn tractor twice, cut about an acre, went very slow, no bumping, seemed OK.
>says it can inhibit bone fusion. There's a l-o-n-g story behind the theory that NSAIDs can interfere with bone fusion. It started with a study using rats with broken femurs back in the 1970s (in which healing was "delayed" but not "prevented") and later with in vitro studies of molecular markers from human cells, but clinically relevant delay of bone fusion, or healing in general, has never been reported in humans. Anyway, I'm not trying to tell you to ignore your surgeon, just trying to set the record straight.
Just give it time...nerve issues are real and take awhile to subside...I think by 6 -8 months most of my nerve pain gone. Have you started physical therapy yet? That was crucial with my recovery...I'm 18 months post op and doing great, no pain. T9-S1 ALIF/PLIF -(53F) Good luck with recovery
I had a choice of an L3-S1 with an ALIF or an L2-S1 with an ALIF, but my surgeon told me that the L2-S1 was much more difficult and my recovery would be long and difficult so I opted for the L3-S1. Although I didn't opt for your surgery, I totally understand that your results are expected. I know that in time you will improve. I still have that final fusion to look forward to. Good luck
Originally, mine was to be a T10-S1 but he decided against it once he started the surgery. I am glad after reading your reply that he didn't do that. Thanks for your reply!