I had an ALIF surgery Sept 10, '25. I am F, 72. An L4-L5 fusion. I do have a bit of osteopenia, but was not serious enough to interfere with the surgery. Other than that, plus lordosis in my lower spine (swaybacked!) I had no other complications like obesity, diabetes, etc. I am NOT athletic---I don't do cardio, weights, pilates, etc. Yet am fairly 'fit' just with doing daily chores around the house and with our animals. That being said, I was in excruciating pain last summer because L4 vertebrae had slipped over L5 (or was it the other way?) and was pressing on the spinal nerves. At times, the pain was like grabbing on to a 220V electric cable. I survived on ice packs and 2 hydrocodone pills per day from late July to the date of surgery. Now for the good news: surgery was a resounding success!! I had 2 great surgeons at the hospital only 25 mi from my home (northern MN) Happy to share names if you like. I was in the hospital Wed and released on Fri. On some oxycodone and plenty of ice packs both on my tummy and back for about a month. Yes, there was pain, but NOTHING like what I suffered through all last summer. The doc said no BLT's (bending lifting twisting) for several months, lifting nothing heavier than a gallon of milk. As for physical therapy, as I mentioned before, I believe I have enough exercise in my daily activities of climbing stairs, walking, laundry, cooking, etc that I don't need to have any special exercises. I do sleep in a very firm, power recliner as it supports my back more than a mattress or squishy recliner. If you don't have a power recliner, I highly recommend renting or better yet, buying one. Well worth the investment especially when trying to get up after sitting down , and may come in handy later on. Every morning I get up and say 'thank you Lord' for getting me great surgeons and family help both before and after surgery. I realize that at my age, I am not going to 'push my luck' by trying to do the things I used to do 10, 20, or 30 years ago. As long as I can function at a reasonable level and take care of basic daily living, I'm good with that. One last piece of advice: Spinal surgery is a delicate, serious procedure. After surgery, be kind to your body! Give it plenty of rest and time to heal. Don't rush to get back to 'normal living' ---you may have to adjust to doing or not doing a few different things for the remainder of your life. I too was concerned about 'going under the knife' with this surgery, but honestly, I could not stand the agonizing pain last summer, so I did my research on the docs, and decided to go for it. And I am so very, very glad I did. I wish you all the best with your spinal journey, please keep us posted, and if you have further questions, please reach out to me.