I am set for the XLIF May 3rd for L4-L5. In 96 I broke C1-C2 and L3-L5 in a motor vehicle crash. No surgery was performed then and I had only minor pain until 2008. After seven Doctors telling me My only option was surgery, I have decided to do it. I was originaly set to have an ALIF, but came across the XLIF. My doctor at the time said he could do that procedure as well. I told him that I came across a doctor through Nuvasive website. I informed him of the doctors name and he said to see him bacause he was the doctor that tought him as well as doctors in the Southeast.
I am in Law Enforcement and was told that I would be out of work from 4-6 weeks. How has physical therapy been for others and how long did it take for you to return to work?
I had the XLIF fusion in November of 2008. I would not recommend getting it. It made me worse and now I can't sit or stand for long. My hips ache like heck now and my legs have sharp pain which is new as well. I can't lay down and get comfortable as my lower back,hips, legs hurt like you wouldn't believe. I lay on my side and the pain goes to my leg, I switch position and it goes to my foot. I can't get comfortable to even sleep now.
My back is always hot and spasm'd. I've been on flexiril (cyclobenzaprine) for 9 years and have a feeling that drug it has been tearing my guts up. So I went to the FDA Drug website and they say that drug is only to be used 2-3 weeks max. It's not good for your internal organs either and you can read the tests where it killed the rats by destroying their organs. I quit using it trying to get the pain in my guts to stop and holy crap the muscle spasms are just tearing into me even worse. Either way I'm screwed.
I regret getting the XLIF and wouldn't suggest it. Before the surgery I was a little better and didn't have my hips/legs bothering me as much. I also can't walk normal now and waddle like a duck.
That surgery destroyed my life. I originally herniated the L4/L5 disc in my back which exploded into pieces. When I was active duty I had the broken pieces of disc taken out but it got worse and they wanted to fuse my spine in 2004. The military pushed me out with a Disability Retirement in 2005, I get $0 a month from that. Got rated 40% disabled by the VA and get $600 a month from them. Now after that XLIF surgery I can't work and we are screwed. Try supporting a wife and 2 kids on $600 a month. The wife told me to apply for Social Security Disability and we did, but they are bankrupt and I'm not expecting anything from them. Everything on the internet says they refuse Disability claims on about everyone.
If you can somewhat function and still work bringing in money, you don't need this surgery.
Never returned to work. Changed my life. At the time in 2008 no neg stories. Everything written was positive. Didn't tell u about permeant nerve damage. Went in walking left in week chair. And no other doctor wants to touch u afterwards so forget getting help or someone to fix the mess. What can pt do if nerves are severed.don't have this surgery.
Please do your research on this surgery. it is not what they make it out to be. A lot of us will end up with damage to the psoas muscle and femoral nerve. Mine was severed. i was an active person with a son and husband who enjoyed dancing, spinning, tennis, wallking. Now I spend my days on strong pain meds. In horrible pain, and its been shy of 2 years. My life is over as I once it. I was told y the docter that he wouls have me up the same day and back to work. guess what his life goes on as normal mine doesn't.
Sorry to hear that. I just met with a surgeon yesterday for L4-L5 disc deterioration and nerve compression. He said with XLIF, success is virtually assured and that he has never had one bad result in 200 patients, also that I'd be walking that same day. My partner was more skeptical than I was (the doc seems like a nice and sincere guy working for a top New York hospital, well known, etc.) Reading these posts I'm less certain now. Hope you're doing better!
Welcome to the board. There will always be people who are unhappy with the outcome of a surgery. In spine surgery in particular, there are no guarantees as to how it will turn out. I would suggest you do not enter into this without very careful consideration. Do as much research as you can.
You can type XLIF into the search box and you will see many earlier posts pertaining to various people's experiences with this particular surgery.
I would assume that you would be in much better hands with a surgeon who has done this procedure hundreds of times. Perhaps this was not the case with other posters who are reporting less than successful outcomes.
Don't be wooed by the "walking the same day" claim. ALL spine fusion patients are expected to get up and walk the same day. Just because you can do it doesn't indicate the amount of pain it may cause to accomplish it!
Also I would just add that a doctor's or the medical profession's definition of "success" is often VERY different from that of the patient. My first fusion was a success to my doctor. He proposed a PLIF for L4-5. He accomplished the surgery without incident. My recovery went smoothly and I healed properly. On paper my surgery was considered "a success." However, I ended up with the same pain and inability to stand or walk that I was dealing with prior to surgery. The fusion did not resolve my issues.
If you hang around forums such as this long enough or talk to many people who have had spine surgery there is a common experience for many concerning the word "success." Many patients are left with more pain than they expected. They then learn that six months out, as far as their surgeon is concerned, he did his job, (and did it well, as they are quick to point out!). At this point, many surgeons are finished with the patient. If he or she is still in pain, there is a referral to a pain management physician. But, often the patient's surgery is recorded as successful.
I mention this not to discourage you but just to say go into this with your eyes wide open. Some surgeons have a tendency to make a fusion seem like a simple solution to the patient's pain issues. But it is important to know that any back surgery is quite different from a regular operation such as an appendectomy. In that sort of surgery, the patient goes to the hospital, has the surgery, is in some pain during the initial healing process, but then heals and is able to resume his/her usual routine. Back surgery for most people is a life-changing event. The surgeon cannot restore the patient to the way he/she was prior the the injury or the advent of pain; he can only perform a procedure to hopefully less the pain, and to stabilize the spine if necessary.
Recovery comes in baby steps...and again, I am speaking in broad generalities...but it holds true more times than not. Once the patient recovers from the surgical event, there is still much healing left to be done. In some cases, muscles that have been overcompensating have to learn a new position, a new way of helping to hold the individual upright; the person needs to train himself to use proper body mechanics and posture so as to create a more healthful environment for the spine, etc. Nerves may need to learn new positioning, depending on whether they were compressed prior to surgery or moved during surgery. I could go on and on, but I'm sure you get the point!!
I cannot speak directly to the XLIF compared to other ways to access the spine, like ALIF and PLIF. You can find information about it on the Internet and on forums like this. I would encourage you to read up on it and also do some research on your surgeon. You want to be as certain as you can that he is recommending the correct procedure for your particular issues. Do not assume anything. Do your homework. You really only have one chance to get this right. Once a fusion is performed, it is not going to be undone!!
Again, welcome to the board. Please post with your questions and concerns. There are many members who have faced the same decision and are happy to share their experiences with you.
The Following User Says Thank You to teteri66 For This Useful Post: surfngranny (07-22-2011)
Many many thanks for your detailed and thoughtful reply. Especially helpful in decoding what counts as "successful" to surgeons. And yes, I do have more homework to do, as I do not even know what those other acronyms (ALIF, PLIF) even are. I thought XLIF was the only game in town!
If you just search for lumbar fusion you will run across all kinds of information. Many of the spine clinics and hospitals have quite a bit of information on their websites, including the two big orthopedic hospital programs in Manhattan.
XLIF is just the newest kid on the block. Posterior lumbar interbody fusion and Anterior lumbar interbody fusion have been done since about the 1940s and there is a procedure that combines the two that is commonly referred to as 360 degree fusion because they first go in from the front and then after that surgery is completed, the patient is turned over and the surgeon goes in from the back. So the patient's spine is stabilized from both sides. These names just indicate the type of surgery that is used to access the spine where the surgeon wants to work.
Recently, the trend has been toward minimally invasive surgeries whenever possible as less muscle is cut through, resulting in quicker healing from the surgery itself. (The amount of time it takes to grow new bone or for the spinal segment to heal remains the same.)
There are videos of these procedures available for viewing on the Internet, in case you are THAT interested.
This month has been the worst month of my life. I've been unable to even get up to go see a doctor. Since they re-formulated Oxycontin it doesn't work for me now. So they put me on MS Contin.
MS Contin constricts your blood flow and makes it worse. Now I'm impotent as well as in excruciating pain. I couldn't figure out WHY I've been feeling worse and WHY I'm now impotent...until I finally read the side effects of MS Contin.
I wish they made pain medicine that worked. I don't know what else to do.
Perhaps a few more consultations with other orthopedic spine surgeons and/or neurosurgeons in your area? XLIF was once thought to be the "next best thing" and now it is starting to show near term and long term results that aren't as favorable as once predicted. There are many spine procedures that were created, then used by many surgeons, and are now no longer used.
Some surgeons can receive excess compensation from the companies that promote certain procedures and thus they being recommending only that type of procedure. It would be nice if a surgeon would lay out all the possible options that he/she feels may work and let you decide. For the surgeon to ONLY talk about one procedure is something to be careful of.
As it was said above, success to a doctor is a full fusion, not necessarily the functionality of the patient, pain level, etc.
Years ago the IDET (Intradiscal Electrothermal Annuloplasty )came out which was going to be the solution to all disc problems. It was used heavily by WC for people with disc problems and then was found to be not successful long term. So it's not something we hear much about any more. XLIF may eventually go this way.
I personally preferred the procedures that have a better history of outcome. My own Orth Spine Surgeon said 2 yr ago he might have considered and XLIF but they no longer do it in their practice, instead they do PLIF, ALIF, 360, and versions thereof. My doctor did a posterior fusion in February with a side incision (5 inches horizontally over my right hip) so they could gain access to the anterior section of the spine without doing ALIF or 360. They laid out 3 different options to me and I chose which way to go after deciding what was going to work best for me.
Everyone reacts differently to the outcomes of surgery. For me I am better but have some stiffness and really hurt when the weathers changes. As for walking the next day, dont hold your breath!!!!!!!!
You will need to take baby steps (Literally). In the beginning you will feel on top of the world, and then the very next day you will feel like a bus hit you three times. Keep in mind that the doctor will be moving parts of your body that are not meant to be moved. Take your time and let yourself heel correctly. DO NOT OVER DO IT! I learned the hard way.
I went with the XLIF because I did not want the pain associated with the cutting of my abdominal wall with an ALIF. If you go with the XLIF you may have some nerve pain in your inner left thigh, since there is a nerve line they will need to move when they go in on your left side. I also added some screws and bolts for added support (Which I recommend!).
Overall I am happy I went through it. After 9 doctors I found one that taught everyone in the southeast and had plenty of experience. I carry 35lbs of gear everyday for my job. I do hurt when I come home but it is mostly due to muscle stiffness.
Do know that if you are on a single income and not married, or a millionaire you will be out of work for at least 3-4months. This did hurt me financially but was worth it to keep doing the job I LOVE as a police officer.
I am going thru the same thing. I had mine Dec. 2008. I just had a ablation on the left side and was set to have it on the right. I still can't sleep, sit stand etc. Try a company called Allsup maybe they can help you . Good luck don't get depressed it will hurt you more. How about vocational rehab for retraining. I keep my daughter in my mind so I can't keep living. Good luck to you. Xlft is a horrible surgery
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HERE is what it looks like after they do an XLIF on you:
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notice how the "glue?" inserted between the discs bulges out in front into your belly?
Also the one side is bulging out. This is 2 YEARS post OP, doesn't appear the bone is fusing. In fact it looks like there's a fracture between the vertebrae.
Those metal pins are floating between the disc and not actually touching any bone. Guess the super glue they goop in there does NOT dissolve and eventually become bone. IS there anything holding me together??????
Hurts like heck! My hip gets RED HOT.
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