I can give you some general information on PLIF. I have had two, a one level at L4-5 and more recently, a 3 level at L3-S1. Here in the US, the patient will be in the hospital 2-3 nights barring any complications. Before the patient can be discharged, he must be able to show that he will be able to minimally function at home -- walk to the bathroom, climb steps if his bedroom is on the second floor, or if his home has steps to access it, etc. The other prerequisite is that the patient's pain must be controlled by a medication taken orally. I think most people will agree that the first week to ten days is difficult. It hurts to move, to turn over, to change position. But gradually surgical pain resolves as it heals.
For most surgical patients the story would end here and he could return to his normal life. With spine surgery, healing and recovery is just beginning. The next several months will be very important as the fusion sets up, the bone grows and fills in. Even though signs of fusion may be seen as early as three weeks, it takes a full year for the bone to grow strong and harden.
At the beginning movement will be restricted. The patient will be instructed to avoid any activity requiring bending at the waist, twisting, pushing, pulling, and lifting anything heavier than a gallon of milk (including pets and small children!
) Most doctors instruct their patients to limit the amount of time spent sitting to 15-20 minutes at the beginning. Walking is the most important activity and is necessary for proper healing and bone growth, to keep the nerves stretched out and to hopefully limit the formation of scar tissue.
Many patients are told to plan on being off work anywhere from 3 to 6 months, depending on the job. Some patients are able to go back a little bit sooner, and some will need more time.
Most surgeons will send their patients to physical therapy at some point after surgery. Some begin quite soon while others wait until 3 months to begin.
I think many patients begin to feel a bit better by the 2 month mark, and by 3 months most are starting to feel somewhat "normal". At six months many patients are able to resume more strenuous activities, but still need to be mindful of their newly repaired back. After a year, strenuous exercise is actually supposed to make the new bone grow stronger. People have been known to engage in activities like kayaking, mountain climbing, scuba diving, etc. (not me!!)
People that have a successful recovery, in general, are those that first of all are very careful in their selection of a spine surgeon, and to the best of their ability, feel convinced that they are receiving the proper surgery for their specific problems. After surgery they are careful to follow their surgeon's instructions in all respects, and are not in a hurry to press and rush their recovery by doing restricted things ahead of schedule. They are diligent about walking short distances several times each and every day. And then further out, they always remember that their spine has been surgically altered, so they always try to use good body mechanics and maintain good posture at all times. They stay physically active and keep their back and core muscles exercised and balanced, maintain a healthy weight and don't volunteer to help their friend move or plant a tree, etc.
What I always try to remind people of is that some doctors tend to minimize the procedure, suggesting it casually. If the patient has not done his research, he is shocked to discover that back surgery is a life-changing event. We are used to something like an appendectomy where the surgeon goes in, removes the appendix, the patient recovers from the surgery and within a couple months, is back to his routine life.
Back surgery is a life-altering procedure. While most people would do it over again, they are never the same as they were prior to the onset of their back problems or injury. Fusion is a BIG surgery and takes a long time to recover from. It requires a great deal of patience and perseverance.
Sometimes, despite all the best efforts and intentions of the surgeon and patient, the results do not turn out as the patient and surgeon had hoped. This brings me to my final comment. There is no guarantee how a back or neck surgery will turn out.
I hope this gives you some information on the process of fusion surgery. I hope I have not been too blunt as I do not mean to discourage you. I just feel it is very important that people understand what they are getting into when they sign the forms for surgery. I think it is easier to have a positive attitude and to move forward when you know what you're entering into....And, yes, I would do it again without reservation.
I'm more than happy to try to answer any questions you might have...it was my first surgery ever when I had my first fusion, and I put it off as long as possible and was terrified. Many kind people on an online forum such as this helped me with all my questions, and I was so grateful. I was so well-prepared ahead of time, and so prepared for the worst, that the reality turned out to be easier than I was anticipating.
