I am looking at getting Posterior Lumbar Interbody Fusion L4-L5 currently waiting on the discogram. My question is what are the long term restrictions I can expect. Everything I have googled talks about the first 3 months after surgery but what about 2 years down the road? I am 34 and relatively healthy. I enjoy numerous sports and outdoor activities, I do my own auto maintenance and fix things around the house. How much of this will I be able to resume after the surgery?
It won't effect your ability to bend or twist once you have healed from the surgery, however, it can take up to a year for your body to fully recover from a fusion surgery and for the bone graft to completely heal.
The no bending , lifting or twisting is usually for the first 3-5 months post op, until the bone graft starts to fuse.
It is only when you have multiple levels fused in that area, usually above L4-5 that it begins to effect your ability to bend and twist.
Best of luck to you,
You'll need to always be AWARE of your back and not abuse it, but you should be able to do just about anything you want. I wouldn't lift an air conditioner by yourself. There's the possibility of the "domino effect", which is when the discs above and/or below the fusion break down because they're taking on the stress from the fused ones. That's why you need to just use common sense. Many people have no further problems for the rest of their lives, but you have to remember once a back patient always a back patient. Just don't do anything stupid!
You might want to read the thread at the top called "post surgery tips". It has a lot of suggestions that will make your recovery easier. And whatever questions you have, please post them. We'll do our best to help you from our own experiences.
My L4-S1 fusion was in 1993 and only this year did I have symptoms return. And, I have very loose ligaments so what I'm experiencing is L3 moving forward (this is not normal - it's something I experience due to loose ligaments and tendons). The good thing is I have been told the L4-S1 area looks great and the discs above that area are also in great condition.
As BlueAtlas says you'll have to be aware of your back. I had my fusion when I was 27 and for the last 16 years I haven't had any back worries. I'm always careful about how much I lift and what I lift but I have done all my normal activities (up until this past April). Part of my problem is the hardware they used - it's ancient by today's standards.
So the plan is to do a single fusion L5-S1 at the end of January. My pre-Op isn't for a couple weeks and was hoping you guys could help me out with some questions. I understand every surgery and patient is different and from what I have read on here I should expect a lot of pain for the first 2 weeks. Can anyone give me a rough timeline of recovery. Will I want to lay in bed or hangout on the couch for the first 2 weeks and then start walks? Also when should I expect to resume physical therapy? I have read the post surgery tips. Do I need to have a lot of entertainment planned (books/movies/video games) or will the pain meds keep me pretty numb and sleepy. I am a pretty independent person and don't like to accept a lot of help, so how much am I going to have to rely on my girlfriend. Will I be physically limited from taking care of myself around the house or will I be able limited by pain. What I mean is will I be able to suck it up and take care of myself for the most part?
While you will need help with some stuff during the first few weeks there are a variety of ways you can make the recovery a bit easier and thus need to rely on others less. I'm the same way - even though I'm a veteran of all kinds of surgery I can't bear having people do things for me unless I really need to. I'm already wondering if I can bear to have my husband do my laundry when I can't.
To prepare for after surgery, take a look at your home and see what it is you'll need and can therefore place at hip height so you wont need to ask for help. Like, what if you keep extra toilet paper in the cabinet below the sink but won't be able to bend to get it. Stuff in the refrigerator and freezer and pantry/cabinets you want to use should be reachable without having to bend, twist or stretch. I place cups, plates and even a frying pan on the counter. So I can make my own lunch without having to ask for assistance. If your clothes are in lower drawers put them at waist height even if it means a pile of underwear and shirts on a counter.
One key thing is a reacher/grabber. You can get them at the big name drugstores for about $10 and it reaches 26-36 inches. Helps you pick up everything from a dropped sock to mail that you drop on the floor when re-entering the house. A long handled shoe horn can aid in getting shoes on and are also inexpensive.
Have extra batteries handy for remotes, extra pillows for comfort behind the head and under the knees, if you'll have a brace have shirts to wear under the brace if it's hard sided (undershirts work well for this), etc.
Sometimes after this kind of surgery your "system" has a hard time getting moving so foods such as yogurt or probiotic items that can get your system back in gear.
Most importantly listen to your body. If you start doing some walking and have pain be prepared to lay back down. I found my couch was too low and not firm enough for me to lay on in the first 2-3 weeks so I was on the bed only. I have an old shower chair from knee surgery and I use that in the shower if I feel at all unsteady.
Will I prefer to sit up or lie down more right after the surgery? Do you recommend moving a TV into the bedroom? Do you think it helps to get up and switch locations throughout the day? Like spend a couple hours on the couch then move back to the bed and so forth. How soon after surgery did you start physical therapy? How much traveling to appointments and stuff is required before I am able to drive myself? I will be relying on my girlfriend for transportation and she is unable to take time off from work.
Your doctor should give you specific post-op instructions that take precedence over any info I share.
The instructions will give you guidelines that tell you how long you should be sitting, laying, walking, etc. In general sitting is very limited in the first few weeks with maybe 15-30 minutes of sitting every few hours.
The medications, pain, and pain meds will make reading books tough. I don't know how you'd survive without a TV in the bedroom as you'll be in there most of the time for at least the first few weeks. (I'm one of those with a tv in the living room, family room, bedroom and guest room). Unless your couch is fairly rigid you won't be as comfortable laying on the couch for a while as it won't be supportive enough.
Driving is limited by the pain and pain meds. After fusion most surgeons have you avoid NSAID meds (advil/ibuprofen, aleve/naproxen, and aspirin) as they are thought to inhibit fusion. Tylenol is fine but most pain meds have Tylenol (acetominophen) in them so don't combine pain meds with additional Tylenol.So meds you take will likely be pain meds such as vicodin, percocet, etc. So you will need a ride to at least the first post op appointment. Some people will arrange the appointments around meds such as getting an early appointment to be able to drive yourself medication free and then go home after and take meds. I would estimate that the earliest you'd drive is at 2 weeks post op and limited distance. So if your girlfriend works traditional 9-5 hours you may need a friend, family member, or even a cab.
I hope this helps! Keep posting the questions as you think of them.
I had C4/5/6 fusion then 4 months later on Nov. 12, 2009 had L4/L5 anterior fusion using the Aspen technique. I now am at the 4-month recovery and understand that full fusion recovery can be 6 months to a year. I was required to go through 4 weeks physical therapy using isometric exercise and will still do the exercises at home for awhile. The exercises are necessary to stretch the sciatic nerve to break up old scar tissue along the nerve path. At this point all pain is totally gone in my right hip and leg. However I am still experiencing left hip and leg pain on a level of about 6 on a 0-10 scale. As a result today I called my neurosurgeon to ask if this is a normal situation, which I think it is. He was in surgery so hasn't returned my call.
I was on narcotic type pain relief for one week and then used Ibuprofen. Finally that caused stomach problems so since have been on Meloxicam, which works fine at 7.5mg twice a day.
After 8 years in Survival, Search and Rescue in the USAF and 3 years in Vietnam my back took some punishment. I wish I had gone through this surgery many years ago, but maybe it was best that I waited until the new Aspen technique came into being.
I'm now 74 years old, so that should give some encouragement to all you younger guys who are a bit leery of getting the surgery
To zhmmy: thank you for your service to our country! I'm sorry you've had so much pain. I hope you get some relief. I'm grateful that men like you have been willing to put their lives on the line. I guess my kids heard me say that enough times growing up, because my youngest has been to Marine boot camp, got discharged pending some medical testing, and is waiting to go back.
I've had to take Ibuprofen for years because of arthritis. My Doctor took me off that and prescribed Meloxicam, a COX-2 inhibitor for the arthritis and Flexeril to help me sleep. I intensely dislike narcotic type drugs like Morphine even though they certainly have their place. I was on Morphine for 2 days post-op but dropped it as soon as possible. In addition to its addictive nature it also has a lot of bad side effects. The worst one for me is that it shut down my urinary tract which caused my bladder to swell to danger of rupture. I had to make a night trip to Emergency for a catheter.
When I had the C3/4/5 fusion I was prescribed an electronic magnetic collar. This I wore 4 hours a day for 4 months, and at that point my fusion was complete. It worked so well that I rigged up a velcro attachment and wear it around my waist for the L4/L5 recovery. I highly recommend using the magnet for speeding up fusion.
I also used a bone growth stimulator with my neck fusion. I don't have the unit anymore but was prescribed a lumbar bone growth stimulator. It's worn 24 hr a day (except when showering). It consists of two 3" electrodes that are stuck on either side of my incision on the back. These have leads/wires hanging off (around 4") that connect to a battery pack unit with wires. We change the electrodes about once a week.