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Arterior Lumbar Interbody Fusion (ALIF)

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Old 05-11-2007, 04:28 AM   #1
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mewcamaro HB User
Cool Arterior Lumbar Interbody Fusion (ALIF)

I am having this surgery in June, which my surgeon said is major surgery, 4 hours, and may require replacing a unit of blood. I would love some feedback from anyone who has had this done. He explained they would go in from the front to do this type of surgery and then remove the 2 bad discs (L4-5 L5-S1) and insert 2 titanium cages and fill them with BMP-2

Needless to say I am very nervous about having this done. I had a Disectomey/Laminectomy in Aug 2005 but still experienced pain. They finally gave me a Discogram (this is a Workmans Comp case and the insurance company tends to drag their feet with approvals) which showed my discs being really bad.

How long were you in major pain after surgery? What was your recovery time? I also heard that you have to wear a brace after long..and do you wear it 24/7?

Anything you can tell me about having this done and the time after having surgery I would greatly appreciate.



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Old 05-11-2007, 04:31 AM   #2
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shawley HB User
Re: Arterior Lumbar Interbody Fusion (ALIF)

Hey don't worry you'll be fine , I here that the front is the best way to get it fixed. i had mine done from the back and had a real hard time fusing. Don't be scared just think you'll have relief soon.


Old 05-11-2007, 04:34 AM   #3
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Re: Arterior Lumbar Interbody Fusion (ALIF)

Welcome and sorry to hear that you are going in for surgery, but in the long run you will probably be thankful.

I had TLIF wich is through the back instead of the abdomen. I am nine weeks and I am still recovering. I think with the ALIF the recovery is suppose to be easier to recover from long term wise...

I am pretty sure Harmony and Bailey both just had ALIF not to long ago.

Regaurdless of which way they do it, there are a ton of us here who've had fusion.

Our recoverys are all different, although alot the same our conditions aren't the exact same, so its hard to compare to others etc. I can tell you the first two weeks are the hardest then it gets easier. But, you I had imagined the worst pain and those two weeks were not like what I had imagined.

There are lots of resources here to find ways to make life easier during recovery.

Best of luck, vette

Old 05-11-2007, 05:50 AM   #4
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kkmom HB User
Re: Arterior Lumbar Interbody Fusion (ALIF)

Hi I just wanted to welcome you to the boards and I am glad you aksed that question, because I will be getting s similare procedure in september. I am sure you will get a lot of respones, take care and best wishes

Old 05-11-2007, 07:20 AM   #5
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Re: Arterior Lumbar Interbody Fusion (ALIF)

Hi Mewcamaro, and welcome to the board.

I had a 360 fusion last September. A 360 goes in first from the front, then you get flipped over and they go in through the back. This was my second fusion. The first one was 30 years ago and was just through the back.

In my opinion, the front incision is much harder to recover from. For me, that might be because I've had back problems for most of my life and have strong abdominal muscles that I've learned to use well to lessen the stress to my back. Having those muscles compromised was very hard for me. However, even though it may be harder to recover from, there is a higher success rate going in through the front. The highest success rate is doing the 360. I was showing the beginning of fusing at only 3 weeks post-op. At 6 weeks, it showed even more, and by 6 months I was completely fused. I am now about 7 1/2 months post-op. I still have some pain, but it's different pain from what I had before and is much more easily controlled with some pain medication.

The BMP has a very good track record, too. It has been shown to greatly increase and speed up bone growth after fusion.

You asked how long to expect to be in a lot of pain. I would say a few weeks, depending on what shape you're in before surgery and your activity level afterwards. You'll want to just rest as much as you can, but you also need to walk. Walking increases blood flow to the spine and will get the bone growth going. It was most painful getting up and down from the bed at first, so I always took advantage of already being out of bed whenever I got up to use the bathroom and walked for as long as I could, usually about 10-20 minutes in the beginning. Other than that, I was pretty much just lying in bed. I was able to go back to church at 9 weeks, although I sat at the very back so I could stand up when I needed to. Sitting is the hardest! I stood for the entire sermon for quite a few weeks.

For me, three months was the first really big turning point. I felt so much better and had energy again. I steadily improved from there, but again at 7 months I felt a huge change. My walking pace picked up and I could walk longer and longer distances.

The brace varies greatly from doctor to doctor. I had a TLSO, which is a hard plastic brace that goes from your armpits to your hips. It pretty much covers your whole torso. I wore mine for 6 months, but that's longer than most people wear them. I was told not to wear it when I was lying in bed and that if I got up to use the bathroom and was going to lie right back down, I didn't have to put it on. Otherwise, I was to wear it at all times when I was out of bed.

There's a very good thread in the stickies at the top of the page called "post surgery tips." It will give you lots of suggestions for things you can do to have an easier time recovering. The best suggestion I got from there was to get a grabber tool. If that thing had a counter for how many times it had been used, it would be well into 5 digits! My sixteen year old loved to play with it and once asked me, "mom, what would you do if I broke this?" (with a little grin on his face!) I just answered, "I'd have to call you a few hundred times a day to get things for me." Needless to say, he was careful not to break it!

There are lots of folks here who have been through it already and are happy to answer whatever questions you have as well as we can. Remember, we're not doctors. But we've been there and done that and can share our experiences with you.

Prepare as much as you can ahead of time, and you'll do fine. Read that thread! It will be a huge help to you!

Take care,

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Old 05-11-2007, 08:10 AM   #6
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Re: Arterior Lumbar Interbody Fusion (ALIF)

Hi Mewcamaro,
Welcome and good luck! As others have stated it's rather hard to give exact info to your questions. I have had 4 fusion surgeries in the last 3 1/2 yrs. and all of them even tho they were fusions I had different recoveries each time. I wore two different types of braces for different amounts of time. I had the front & back approach done within 4 days of each other. For me the front approach was the easiest to recover from out of all of them. I truely felt no pain in the front at all from the surgery, I'm not sure if the back pain just distracted me from the front pain or what. But it was a welcome feeling none the less. I hope you have the same experience as well. I too was told that the front is the most successful approach also.

The braces that I wore were on for different amounts of time. The longest time was 5 months all the time except for showering.

I'm sure you will be happy that you had it after it's all over. It is normal to be nervous before hand.

God Bless

"Thru every dark corner is a door to a new light"
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Old 05-11-2007, 10:46 AM   #7
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Re: Arterior Lumbar Interbody Fusion (ALIF)

Hi Mewcamaro,
I had ALIF L4/5 and L5/S1 6 weeks ago and I know how much I appreciated this group of friends who told me their experiences, so I will answer whatever I can from my experience. I had cages put in place with screws and the cages were coated with a product to stimulate bone growth for fusion. I did not lose blood and didn't have to receive extra. The first thing to remember would be to keep your pain medication on board when needed. Number two would be to keep your bowels moving. While in the hospital, I got up the first day and walked the second day. Surgery Tuesday and home Friday and walked the halls as I could in the hospital. The first week home, I was hit with constipation and required a fleet enema to get going again. I also experienced some left leg cramping when I would attempt to stand. I had to change pain meds because of vomiting. I would have some phenergan on hand in case you do get sick. Those first two weeks are pretty much a blur now because of so much sleeping. My husband went back to work right away, so I was alone, I had people checking by phone often. At my two week post-op my M.D. told me not to be a martr with pain meds. I can only tolerate Darvoset and take flexoril at night now. Each day I would walk in the house each time I would get up to the bathroom. A stool riser is great, a reacher is an absolute necessity even to this day. I was able to get a laptop just before my surgery and it has been my lifesaver since being home.

Initially, most of my pain was from the incision but as the weeks have went by, I have less. At week 5 and 6, I can really see a difference. I feel like the anesthesia feeling is gone! I wear a back brace made by Aspen when sitting or walking. I still have incision and abdomen pain, but it is tolerable and just part of the healing process. Sitting is the hardest and causes pain to the back. I am not back to work yet and will see my M.D. May 24. I am very anxious to see if I am fusing. I am now walking everyday 1-2 times for 30-40 minutes each time. Walking is very important and rest, rest, rest. The initial pain I had before surgery is gone. At this stage of my recovery, I take 3 Darvoset and 1 Flexoril each day. I am very happy with the results.

I think it is very important to be mentally prepared for this surgery, it is major and I had some down moments, but this is the place to get picked back up. These people are amazing and so giving, so use this board as a resource to vent, cry and laugh. We are here for ya.

Please let me know if you have any other specific questions. I wish you the best of luck!

Old 05-11-2007, 12:12 PM   #8
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mewcamaro HB User
Re: Arterior Lumbar Interbody Fusion (ALIF)

Thank you all for replying and making me feel so welcome since I am a "Newbie". Its nice to know there are such nice people out there I can reach out to who have had the same surgery that I will be having.

You all have given me such good information and have put some of my fears to rest, of course I know the day of surgery I probably won't feel that way, but at least I know what I can expect.

I will keep you all posted as to how everything goes....thanks again!!


Old 05-14-2007, 11:28 PM   #9
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Harmony5 HB User
Re: Arterior Lumbar Interbody Fusion (ALIF)

Hi mewcamaro! Welcome to the Board! I'm sorry I have not replied until now. I had an ALIF March 27th (same day as Bailey07) and I was not in major pain after the surgery much to my surprise. I expected much worse in the hospital. The last day in the hospital (I was in from Tues. - Friday) I had no pain med because I didn't need it. I never had a morphine pump which I expected to have either.

My surgery was also 4 hours. I did not have to donate blood nor did I need any. My main pain was the incision when I moved positions in bed and tried to get up. After I moved, the pain was better. The incision pain was there for 2 weeks. It's fine now and I am 7 weeks tomorrow. My pre-surgery pain was gone and I was doing well. I was given Percocet to take at home when needed so I tried it a couple of times and it made me sick so I didn't take it. I was happy that I was able to walk and stand without the pain I had.

Now, I don't know what happened the past two weeks as the pre-surgery pain is coming back and I'm in much more pain. I now have Darvoset to take and it doesn't help my pain very much as I can only tolerate 1/2. I need to find out what's going on as I don't think this is the normal post surgery pain as it's more nerve pain.

I wear the brace while I am up but since 6 weeks I was told I can cut back on wearing it. I still wear it since I feel less pain with it on.

I'm glad I had the ALIF because they don't have to move the muscles in the back so I think it's less painful. I was very confident in my doctors. I had the Neurosurgeon and the Vascular Surgeon who did the open and close.

I wish you the best on your upcoming ALIF. I was very concerned before mine until the last two weeks when I had peace about it. This board helped me a lot, plus many friends praying for me. It was way better than I thought it would be.


Old 05-15-2007, 03:46 AM   #10
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Re: Arterior Lumbar Interbody Fusion (ALIF)

hi mewcamaro,

I had a double fusion from the front last june with cages and BMP at L3-4-5. at this point Im doing great, one level fused and the other almost there. my pain is 90% gone, I gained about an inch back in hight and am quite happy with the results.

everyone here has already given great replies as to what to expect (and youll have noticed varying recovery times) so Ill just give a brief rundown as to what I went through.

when I woke up I was in no pain, I actually thought they had not done the surgery. I had to ask. I had no drain, just 38 staples (looked like I had a zipper in my belly ) although I didnt see that till they changed the bandage. they inflate your belly (it lifts the skin away from the intestines so they can just cut the skin during the incision) so dont be surprised if you look pregnant when you wake up (the "pregnant" look lasted about 3 weeks; the gas is absorbed into the body). I was already on the pain pump when I woke up. a word about the pain pump.. it gives some meds automatically but when you press the button it will give additional meds - but only up to a predetermined level, so you cant give yourself too much. do thumb exorcises now so youll be ready. press it as much as you want, it wont allow too much. if you do feel pain tell the nurses, they will adjust it up.

they will have you walking the next day. walk as much as possible, its good for your healing and also with any gas you may (probably will) get. getting up is the hard part (practice the "log roll") but once up I walked all over my floor. the gas did suck, your intestines are settling back into place and waking up so they need to work themselves out. that only lasted a day for me. they can do unspeakable things to you to help with the gas (think enemas) but thankfully I didnt need any of it.

once I was home the 1st couple weeks werent fun. I have to be honest there. but nothing super bad really. youll spend lots of time sleeping because of the meds. about the 3rd week there was a marked improvement. after about week 4 I was moving around pretty good.

for the next 2 months there were times I wondered if i had made the right decision having the surgery as nothing seemed to be improving. but it was, just sloooowly. so at about month 3 that was another turning point. then another longish stretch of a couple months where again I wondered if I had made the right choice due to lingering aches and such. but its was just the body healing - the "good pain" so to speak. I guess month 6 was another turning point.. when I reached that I realized that almost all the aches were gone, I had good mobility and all the unpleasentness of the surgery and recovery were a distant memory. at at this point I have to watch myself that I dont do anything stupid as i hardly ever think about my back now.

as for the TLSO brace: I wore mine for about 2 months any time I was not in bed. my doc also told me "couches arent beds"

be sure to ask any questions you have no matter how trivial it may sound. this board has been a lifesave for myself and others here.

edit: well I guess this reply wasnt really "brief" heh. just wanted to add that even though I gave blood I didnt need to use it. they use a rig called a "cell saver" that catches any blood you may lose and puts it back into you. the donated blood is only for emergencies.
back surgery in JUN 06 - two level ALIF (L3-4-5) with cages and BMP - SUCCESSFUL!

Last edited by zeroman; 05-15-2007 at 03:52 AM.

Old 05-15-2007, 02:24 PM   #11
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Re: Arterior Lumbar Interbody Fusion (ALIF)


I had the 360 surgery. I had a 3 level fusion with cages. I also had a 16 degree curvature fixed. Had rods pins screws etc. I lost three units of blood. My 3-5 hour of surgery turned into 8.5 hours. I also turned into an anomoly. When they got me up the day after sugery my back broke. Unfortunately the staff didn't listen to me and continued to get me up twice a day to walk with a broken back. I had an addtional 5.5 hours of surgery and am now fused from T9 to my sacrum. THat being said. I had a hard turtle shell brace that I wore for 5 months. If I wasn't in the bed the brace was on my body. Don't let anybody fool you. That puppy may keep you stable, but boy is it hot! LOL. I was extremely bloated from the gas from the incisions. In fact my hubby said it was a good thing he know who I was or he wouldn't have recognized me. It does go away.

You learn to log roll very quickly. It will become a ssecond nature thing. You can't roll any other way so you might as well learn to practice it now. I keep offering to teach classes at PT for $10. They laugh at me...

I am still in PT..2 years into a 4 year program to regain use of my right leg that I lost when my back broke.

Your doctor will give you pain meds that will take care of whatever you experience. Take what you need to cover the pain. Give you body the chance to heal yourself without having to fight the pain also. That is the most important thing. You need to heal without fighting pain too.

Take a deep breath and let go. We will all catch you with our prayers and all will go well. hang in there.....[/COLOR]

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