Welcome to the board. I'm about your age and have had two fusions since turning 58 (my first surgeries ever) so I hope I can answer some of your concerns.
My last surgery was June 2010 when I had a 3 level posterior fusion...I was already fused at L4-L5, but the surgeon added on the two adjacent levels, so I am now fusing at L3-S1. I haven't been x-rayed since June, at which point I was almost completely fused, so I imagine it is complete by now. I mention this so you can see it can take a LONG time for a multi-level fusion to completely fuse and set up solidly.
My first fusion was considered a "success" but it never resolved the issues I had prior to surgery, so in my mind, it was not what I considered a success.
But at the time I had it done, there was disagreement among the surgeons I consulted with as to how many levels needed to be done. At the time I was in shock that I needed any fusion at all, so I opted to go with the one level. I figured if it wasn't enough, we could go back in and do the other levels...which is ultimately what ended up happening.
I am going to respond to your questions with answers that are appropriate for a fusion surgery that goes well and does not involve complications, and with times that are considered statistically normal. You may heal slower or faster...you may have more or less nerve damage going in, etc...so take that into consideration with anything you read on a board like this!
First I commend you for trying to get into good shape prior to having surgery. That is very smart and will help assure a good outcome...particularly if you have done your homework in selecting your surgeon. That pick is the MOST important decision you will make regarding this surgery. Not all surgeons are skilled at doing multi-level fusions...so choose carefully!
I have not had a laminectomy by itself, so can't really tell you how much more difficult you may find recovery from a multi-level fusion...but there will be a difference.
First, do you know what type of fusion you are having? Will it be open or will they try to do it minimally invasively? Do you know if it is PLIF, ALIF or XLIF?
What type of bone graft will they use? It is important to know this before going in.
I would imagine since you have had a prior laminectomy that they will go in from the back, and probably do a PLIF...but that's just one layman's guess!
In any case, the first week will be difficult, and you should plan on having someone to help out, if possible. How soon you can drive will depend on how long you need pain medications. You will have restrictions on how long you can sit. Do you need to sit if you go back to work?
I do not think my experience was necessarily typical, but I felt really good surprisingly fast after my last fusion. I only took pain meds for the first ten days, and I think that made a big difference in my recovery. My first fusion was actually much more painful and took longer to recovery from...it may be because the discs were left in place with the second surgery, so I didn't need to have a spacer inserted to maintain the disc space.
Anyway, I would have felt OK to go back to work for several hours per day at a month...but I wasn't allowed to sit for more than about 30 minutes at a time at that point.
I felt fairly back to normal by six months, and by a year I thought I was finished with recovery. However, now at 20 months out, I realize that I am still making progress...but I think this would be considered the "fine tuning." Most articles you'll read and information that surgeons pass out indicate that it takes 12 months for the fusion to set up and get strong, and for a patient to get strength levels back, etc. But if things go OK, you will start feeling pretty good by 3 months, and pretty much back to normal (whatever that is
) at 6 months.
A conservative surgeon will tell a patient to count on being off work 6 months...but I think many go back at 3 months. I know people who went back to full-time work at 2 months...but in most cases, it proved to be close to "too much."
I'm happy to answer any questions you might think of. There is a "stickie" post near the top of the first page of the topics on the back board entitled "Post-Op must haves" (or words to that effect...). It is comments of what other patients have found helpful during recovery. You probably won't need 99% of the stuff, but it is useful to read through as it gives you an idea of what life will be like immediately after surgery and in the early weeks.
Most people recommend getting a "grabber" which is great to reach anything you drop so you don't have to bend over. I found a raised toilet seat to be of help...but not everyone needs or wants one. It may depend on one's height. And the final thing I loved was having a satin bottom sheet on the bed. While in the hospital, it was so difficult to reposition myself, and I felt like I was stuck to the bed with velcro. With the satin sheet, it is easier to roll over and to do the "log rolls" for getting out of bed. But with your PT routine, you may be sufficiently strong that this isn't an issue for you.
I realize I was in worse shape before my first surgery than I was at the time of the 2nd fusion...as I had been doing lots of PT in between the two. Before the first fusion my physical conditioning had really suffered as I couldn't walk or stand for more than a short time for years prior to fusion.
OK, that's it for now. Don't let the stories you read on the board scare you. The patients that had successful outcome do not stay on the boards...so what you read is biased toward those unhappy with their results.
I am very, very pleased with the results of my revision. Oops -- I just saw where you're having TLIF. My only words regarding that is be darn sure your surgeon has done the procedure successfully MANY times. Be sure to read online regarding TLIF -- one of the negatives about that approach is that some patients report terrible hip and leg (thigh) pain following surgery. The XLIF approach requires blunt dissection through the psoas muscle and the traversing lumbar plexus. ...So, just be aware of this...do some reading and maybe talk to your surgeon about possible complications and why he feels this is the best surgical procedure for you.