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Old 12-27-2012, 04:23 PM   #1
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Isthmic Spondylolithesis, 1 month post-op PLIF

I wish to share my recent experiences for the benefit of others. I am a 52 y/o man who has lived with a grade 1 isthmic spondylolithesis of the 5th lumbar vertebrae for over 30 years. I am currently one month post-op from a one level PLIF (posterior lumbar interbody fusion) of L5-S1.

Over the last 30 years I have tried just about every non-surgical treatment for the condition. About 10 years ago I established a relationship with a doctor who specializes in nonsurgical treatment of back pain and sciatica. I have been fairly comfortable and able to live a pretty normal life, with some minor limitations, since then.

About a year ago my condition began to slowly deteriorate. I had reached a point where I had severe, sharp, biting sciatica all the way down both legs with associated low back pain after standing or walking for as little as 10 minutes. I was also having difficulty sleeping. About 3 months ago I spoke with my doctor, who then ordered another MRI. The exam showed that there had been significant deterioration since the last exam about 5 years previous. The was severe impingement of both sciatic nerves and other changes. When the doctor asked about surgery I knew it was bad, since I had previously made it clear that I wished to avoid surgery. I was referred to a surgeon in the medical group who specialized in spine surgery. This doctor had obtained the extra training for this type of surgery and performed only spine surgery. We scheduled the surgery for December 3rd. This permitted me to make arrangements with my employer, as I knew I would be off work for a significant period of time.

Before my surgery I took the opportunity to review the post-surgery tips at the top of this board. I would strongly encourage anybody having surgery to check out this thread, as it is packed with a great deal of very helpful information.

I was in the hospital for a total of three days. I was fortunate to have my spouse, an experienced RN, with me the entire time. While the hospital staff was competent and very considerate, having an advocate was extremely helpful. I would strongly suggest that, if possible, to have such an advocate during the hospital stay. While I understand that not everybody can have their own private nurse, having somebody clear headed can be a great help. Another suggestion would be to have the hospital make every attempt to NOT discharge you at local rush hour. That happened to us. Leaving a major metropolitan area at rush hour can be stressful during the best of times.

Here are some of the things I have noted over the last month. First, you will have to have somebody to help you out once you are home. Even such basic activities as simple bathroom duties cannot be accomplished without help. Also, have plenty of comfortable clothes to wear. I have lived in pajamas or sweat clothes this entire period. Try not to be a hero. Take the pain medication as directed to stay ahead of the pain. Work with your doctor to find the correct dosage and schedule. I have found that, in addition to low physical stamina, I also have low mental and emotional stamina. Having books, movies, and such during this period has not been very beneficial. I just havenít had the desire to stay with anything for very long. One thing I havenít really seen addressed is the topic of depression. From what I have learned, depression is not unusual in people who live with chronic pain. For me, the depression was exacerbated after the surgery. It has improved greatly as times goes by, but was an issue.

Have a comfortable chair and plenty of pillows. You will stay in bed or the chair a lot of the time. A nice cushioned lap table has also been nice. I am fortunate to have a tablet computer, which has been very useful. Another thing I have found very useful is my cell phone. It has allowed me to stay in communication with my wife via talking and texting. This allows her to perform other things necessary to the function of a normal household.

The pain levels have dropped steadily over the month. I did have a great deal of deep nerve pain after coming home. It was more of a strong, deep ache versus the sharp sciatic pain. The surgeon said this is normal after the surgery and will gradually decrease. This has been the case. The staples came out at the two week post-op visit, which was a great relief.

Would I do this again? I have to answer yes, as life had become intolerable. Has it been easy? Absolutely not. Will it work? Well, so far I have not had the sharp, stabbing, debilitating sciatica since the surgery. Only time will tell how all of this works out. I hope to post at 6 months and one year post-op to let people know how this adventure has turned out for me.

 
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Old 12-27-2012, 06:18 PM   #2
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Re: Isthmic Spondylolithesis, 1 month post-op PLIF

Thanks for the very detailed post of your experience with the type of surgery you had. It sounds like things are going smoothly for you.

Were you advised to limit the amount of time you spend sitting? Some surgeons are very strict about limiting their lumbar patients to about 15 minutes at a time.

Also I hope you are taking frequent short walks to stretch out the spinal nerves. This will help to keep scar tissue from attaching to the nerves as it begins to form and fill in. Fr.equent, short walks are more beneficial than taking one or two longer ones.

Drink lots of fluids and also remember to get plenty of rest. It takes a lot of energy to grow new bone cells!!

I will look forward to your updates and hope you will come back if you have questions that arise in the meantime

 
Old 12-28-2012, 09:08 AM   #3
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Re: Isthmic Spondylolithesis, 1 month post-op PLIF

Please forgive me for leaving out that important detail. I was advised to limit my sitting to one hour.

My surgery was a pretty standard PLIF. It was a little different because I did not want cadaver bone used during surgery. As i was told, polymer implants with the same characteristics as human bone were placed into the disc space, along with my bone pieces. This expanded the disc space by about 2-3 times. I have hardware with grafting along the back of the vertebrae. So far so good.

 
Old 12-28-2012, 12:45 PM   #4
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Re: Isthmic Spondylolithesis, 1 month post-op PLIF

To be on the safe side I wouldn't sit that long so early in the process. Sitting puts 30% more stress on the discs than other positions.

Did you have a cage with a bone product graft?

 
Old 01-01-2013, 04:13 PM   #5
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Re: Isthmic Spondylolithesis, 1 month post-op PLIF

As explained to me, a synthetic polymer cage/spacer was used along with my own morselized bone. I have tried to limit how much I sit at any one time to less than the amount I was told I could sit.

 
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