Journey from foraminotomy to ALIF (Anterior Lumbar Interbody Fusion)

@annie1
I was hoping after having a MILD procedure that didn't work out that a Foraminotomy could be done, but I have too much tilt to my spine that it is not an option. My surgeon also told me that he does not like to do forminotomies as they usually don't last and end up doing a fusion anyway. I guess if I could have had one i would have just to push a fusion farther down the road.

@annie1 I wish there was a spine support group too! Diagnosed with moderate degenerative disc disease after a work related injury10/25.... strained back....Dr.advised PT ASAP,but, I was having pain after 2 months of pt. I was asked why didn't the doctor+workers comp let me heal at home first.? Good question! I called university orthopedic you see a spine doctor. My appointment is 3/12. Waiting to have an mri for possible pinched nerve in neck.🙏🙏🙏

Hi again @annie1 et al
My appointment with a third Nuerosurgeon (NS) went summarily like this:
Chatted about rugby union for a while!
Then down to business.
I need an ALIF as no NS can access the L5 nerve foramen without cutting part of the obtruding pelvis away. So a foraminotomy is not an option (where NS #2 said that's what he recommenmds as minimally invasive). NS 1 said I need an ALIF, and NS 3 has said the same thing.
So now it's a matter of when I'm adequately mentally prepared to have it done, along with when both the NS and a Vascular Surgeon (VS) are ready to perform it. The VS is necessary because of the significant veins traversing that area (L5-S1).
It'll be a major surgery with 3 - 5 days in hospital (mostly to ensure my innards have settled after being shifted around to access the spine anteriorly) and another 4 - 6 weeks at home. Then gentle strength-building for a few more weeks and possible back to full recovery (earliest) after 3 months. I'm fit and healthy, so I'll aim for 3 months!
So who's had an ALIF (Anterior Lumbar Interbody Fusion)? What can I expect?

I've also been warned that the level above (being L4 - L5) is bone-on-bone already and the NS is surprised the nerve isn't compromised here too. I'll need another surgery soon (and when this level starts compressing the nerve) where the vertebra are held apart with metal "springs" to allow for a little rotation and to prevent further compression.

Lots to look forward to......not.

My involvement with those joints was part of total lumbar spine surgery, so I had open back surgery. The end result for me was better, but not without pain, but pain I could endure. Each surgery I had was 5-7 disks, in addition the surgeries were long 12 hours due to so much damage to my joints. I hope your pain is lessened.

My neurosurgeon had previously (13 months ago) said to me, "it's a matter of when, not if".

I saw him again on Friday, expecting the worse. I have two levels, from L4 to S1, that are bone-on-bone, with the nerve root at L5 (between L5 and S1) significantly flattened in the exit foramen. This is causing significant issues with my left leg and, since the issue is mechanical, a mechanical solution is required.

I have been given the details, but I declined theatre in 3 weeks time, opting rather for the surgery on 20 July. He will jack up the vertebrae (L5 - S1 contact) and wedge in a titanium cage interspersed with bone fragments from the bone bank. Then I will be turned over on the table, and have pedicle screws inserted on both sides locking in L5 to S1.

I believe recovery takes a while, so here I am looking for anyone else whose had an ALIF with pedacle screws, and what was their experience and recovery time (and recovery regime)?

I have the exact same issue just haven't made it to surgery part yet and L2-L5
Wife has had 6 fusions no ALIF but PLIF with screws and rods.
She was in hospital 4-5 days, then home with me.
They get you on your feet usually the 1st night and start walking as much as possible
If you don't have someone to provide 24 hr care for the 1st few days you may go to a skilled nursing for a bit.
I think most people are on pain pills maybe 2 -3 weeks but varies.
Restrictions were 8lbs for 3 months NO BLT Bending Lifting, Twisting
Recovery time really varies by person, The better your physical condition going in the easier things seem to be coming out.
Driving was I think at 3-4 weeks
Helpful things: Shower Chair, Ice packs, we use the soft ones from amazon and rotate 6-8 of them, side rail on bed is helpful. I have a pole one that squeezes between floor and ceiling that has worked great for both of us. Otherwise they have ones that go under the matteress and stick up on the side. Clamping picker upper
If you want any info on anything just feel free to message me
Good Luck

Thanks, @jlssurplus. This is informative and some of what I was hoping to get out of this forum.
On following up, is sitting a problem after surgery? Since there's minimal BLT recommended, is one required to lie flat as long as possible after surgery or can one go between sitting, standing, walking and lying flat? Or is this more a case of "if it doesn't hurt to sit, then sitting is ok"?
Also, do the rods create discomfort at all (e.g. when lying on one's back", or perhaps you can't feel them at all?
Thanks again for any additional info.

@profevl
You won't feel the rods.
You can sit, stand and lay down, sitting in 1 posistion for long periods of time is not really a good thing. You need to get up and move around.
Walking is the most important thing to do, movement is good for healing.
They want you walking as much as you can.
You just have to go by what your body tells you.

@profevl I can feel the rods when I first lie down. There are also certain chairs I sit in and can feel them. That has been an “ick” factor I discussed with the doctor and he said it’s because I’m thin🧐. It’s not painful, just an awareness. Best to you as you go through this and recover!

@karenoharmon
I didn't know that, my wife has never felt that, I can see where that would feel icky.
When I get mine shouldn't be a problem with my thickness 🙂