Terrified! (Experiences with an ALIF/PSF surgery?)

[DanaGre85]

Hi. What can you tell me about your experience with an ALIF/PSF surgery? I'm trying to advance my knoweldge before the procedure is done in hopes that it calms my nerves. I guess I'm just looking for advice and personal experiences. Thanks

[ajj1001]

Hi, I've not had either but have had an anterior 2 level adr and a posterior fusion. I am a big wimp and have survived. Its not pleasant won't pretend it is, but somehow you get through these things. Getting a plan sorted for your post op pain relief BEFORE the op is the most vital thing. I met with anaesthetists on a few occasions before my second op. Having someone else apart from you who is going to chase up medical staff to make this plan happen.

The other horrendous thing I found was dealing with post op bowel sluggishness. I dealt with this the second time a lot better as I was armed with better ammunition!

Focusing on the end goal of what the surgery is going to achieve and keeping that to mind during the process keeps you going through the bad times.

[Katie]

Hi Dana,

I had an ALIF and an XLIF, at L5/S1 and L4/5 respectively in March of this year. Also an ADR at C5/6, all at the same surgery, with three separate incisions. I didn't find the surgery bad at all, not compared to the years of suffering from intense pain.

I think the outcome depends a great deal on the experience of the surgeon (of course) and the pain control during and post-op. I have been recommending an epidural for that period. My pain was much less compared to friends who didn't have it. I also had constipation problems that kept me in hospital for eight days instead of the expected three.

If you search, you can find my detailed journey of surgery in Brazil with Dr. Pimenta. My husband wrote a journal almost every day for several weeks, and several very kind forum members helped to post it. It may help put your mind to rest.

While I'm not completely pain free, it has more to do with getting muscles and ligaments back in shape, to build my core again.

Welcome to our very supportive forum, and I hope you find the answers you need.

[KBear]

I've never had that surgery either; but I had an anterior ADR. It was no piece of cake, but the end result is worth it. and best of luck.

[DanaGre85]

Well, I have total confidence in my doctor, thankfully. I am most worried about the post op because unfortunately I'm one of those girls that likes to do for herself. It will be hard to get adjusted to having to be helped. I just don't want to do anything that will complicate the healing process.

When you say, "getting a plan," AJ, what do you mean by that and could you give me an example?

And Katie, what kind of exercise do you do to help build your core?

And KBear, thanks.

I already feel a little better, you guys. Thanks

[Rob]

Hi Dana,

I had a 2-level ALIF with posterior stabilization hardware (rods & screws) on 3/15/10. I wrote a fairly wordy post about my experience in a blog that Justin posted for me on 7/20/10 under 'Surgical Outcomes' because it was too long for me to post. If you have an interest it goes from pre-op to ~14 weeks post op and notes my experience with surgery, pain and meds.

The link is http://www.spinepatientsociety.org/forum/attachments/surgical-outcomes/260d1279129514-robs-anterior-lumbar-interbody-fusion-alif-experience-before-during-after-hope-will-help-someone-1.pdf . If the link doesn’t work you can find it under ‘Surgical Outcomes’ posted on 7/20/10 by Justin titled ‘Rob’s ALIF Experience…’.

I’m now ~28 weeks post-op and had my 6-month exam on Tuesday. The CAT scan confirmed I am fully fused!

If I can help please let me know.

Take care.

Regards,

Rob

[ajj1001]

When you say, "getting a plan," AJ, what do you mean by that and could you give me an example?

I had an epidural inserted before surgery for pain relief post op before my first op but this didn't work. I therefore wouldn't go for another surgery until the anaesthetist looked at different options that would work for me when I had my PLIF. With the epidural the pain could be felt on the left side of my abdomen and I wasn't going through that again.

I am sensitive to morphine so that was out as a PCA option so we looked at a few options based on what pain meds I was already taking The doctor wrote these up for post op instructions. This meant that any staff managing me didn't just scrabble around to find a pain doc and knew what to do straight away.

I had fentanyl PCA for standard pain relief and some additional medications for any breakthrough pain episodes. It worked well with only one brief period of extreme pain.

[Katie]

Alison, that happened to me when I was having my first daughter. NOT fun! But he wasn't a good doctor and retired soon after. The epidural I had in Brazil worked brilliantly, so perhaps it isn't your body that wasn't co-operating, but the doctor that did it.

I think the hardest time I had was the two to four months following surgery when my activities were severely limited. I'm used to being busy, and to not be allowed to bend, twist or lift just about drove me batty...I was skirting depression I think. After that I got back my 'moxy', something I hadn't felt in almost a decade...I was standing and walking taller (I gained height after all ) and felt like strutting a bit instead of hunched over in pain all the time.

I was given stretches to do about six weeks ago to start, to loosen my SI ligament which is giving me similar back pain to the original. I put one leg across my knee and bend to stretch then switch. Also started doing the 'plank' where I'm on the floor on my knees and elbows, then raise and lower myself a few times. I'm not explaining things very well though! It helps build my core muscles. I wasn't ready for these for awhile, but find the stretching really helps rid me of the ligament pain when I sit or lean forward when I'm painting too long.

My best advice is resist the urge to do things too soon. You can undo all the good from the surgery. It is very difficult, but necessary.

[ajj1001]

The epidural I had in Brazil worked brilliantly, so perhaps it isn't your body that wasn't co-operating, but the doctor that did it.

They thought It was most probably because of the compression on my nerves from the prolapses which had caused the cauda equina. I've had the same anaesthetist manage me on a few different occasions very successfully.

You're right about the post op period, I don't think there is enough warning about how stir crazy it can send you especially if you are someone who is used to doing everything to look after yourself.

[KBear]

They thought It was most probably because of the compression on my nerves from the prolapses which had caused the cauda equina. I've had the same anaesthetist manage me on a few different occasions very successfully.

You're right about the post op period, I don't think there is enough warning about how stir crazy it can send you especially if you are someone who is used to doing everything to look after yourself.

This scares the 'dog' out of me. I'm terrified that the epidural/spinal will not be effective in my c-section. I already talked with my OB about my pain control issues and the possibility of needing general anesthesia. He said when we get closer to my delivery date that I will have an anesthesia consult. This really should be standard, in my opinion. From what I have read on here, it really seems that there are a lot of us out there with pain medication and pain management issues.

Dana- Just curious, if you don't mind sharing, where are you having your operation? I'm also in the DFW area and I went to TBI; but had surgery in Miami. There are several on here who travel from out of state to go to TBI. I'm glad you are confident with your surgeon and surgery, that makes a huge difference. You really do have to take it easy though and it takes awhile to heal. I thought being young that I would be healed in no time, maybe 3 months max. I was so wrong, took all of a year and I'm still improving. Slow and steady wins the race.