Journey from foraminotomy to ALIF (Anterior Lumbar Interbody Fusion)

@profevl Hello again, I replied to you in another area of this message board a few days ago, and i just saw this question regarding sitting after surgery. The information you received from jlssurplus is very good advice to follow.

I have a standing desk where I have my computer, and I went mainly between the desk and laying down throughout the day. As jlssurplus stated, the main thing is to not lay in bed all day, or even the majority of the day. I would lay down for 60 to 90 minutes, then I would be up for 60 to 90 minutes, and repeat throughout the day.

I didn't sit at home for the first 2 weeks (except in the bathroom), but that was me being a little paranoid about something happening if I sat down. I did have a couple of appointments I went to, and I sat in the car while my wife drove, and everything was fine. I would ask your surgeon just to verify how much sitting you should or shouldn't do in their opinion, but as you mentioned, if it isn't painful, it should be fine.

Reply to several individuals.
I have posted several times. I have had two fusions 30 years apart from each other - one: PLIF [posterior] and one LLIF [lateral / side] - one year ago.
Two specific comments: (A) PLIF was much more pain and longer recovery
(B) LLIF less pain and faster recovery
Please realize every individual is different and one should have the confidence in ones physician's direction.
At the time I had the fusion (Rods and Bolts) 30 years ago - no other method
was offered / or / did not exist. Additionally the "bone graft" was taken from
my hip, which resulted almost with more pain than the back. Today they use
cadaver bone put into a "cage". Thirty years
ago I remained hospitalized for five days /while the recent LLIF surgery I
went home from the hospital the next day. One last thing - I have never had
any discomfort from the rods/bolts put in thirty years ago.
All the best to everyone. peter-paul

Hello, it is looking like I might need an additional surgery on my spine. I had a Lumbar Spinal Fusion at L5-S1 in November of 2025, and my back has been healing well. Unfortunately, I still have severe muscle cramping in my right side (Obliques around to the Flank) to the point I'm spending most of my days laying in bed. The only relief I get is laying on my back, which takes 10 to 15 minutes to calm everything down.

After extensive research, it keeps coming back to a good chance there is a bone protrusion in the T12-L1 and/or T11-T12 areas of my spine. This would require Foraminotomy surgery to shave back the bone that is affecting the nerve(s).

Has anyone gone through with this surgery? I'm wondering how it will compare to my lumbar fusion recovery, which is an entirely different problem right now. Because of the pain I've been in, I have never had the chance to fully recover from the lumbar surgery. Now, possibly having a second surgery has me worried about recovering all over again.

marcd2K, foraminotomy is a simpler procedure. https://www.youtube.com/watch It should be a much easier recovery, but I've only observed the difference in a loved one. Experienced answers will follow. Wishing you pain free results!

Hi @marcd2k - you are not alone. You may notice that I moved your post and combined it with this existing discussion on foraminotomy, because I thought it might be beneficial for you to be introduced to members who have discussed the same:

- Foraminotomy: Has it helped with pain? Major surgery? https://connect.mayoclinic.org/discussion/foraminotomy-1/

If you are replying by email, click on VIEW & REPLY so that you can read through some of the earlier messages and meet some of the other members talking about their or their or their loved ones' experiences.

Fellow members such as @profevl @jlssurplus @morkat may have some input for you on foraminotomy and potentially how it would compare with your lumbar fusion that you feel you've never had the chance to fully recover from due to other spinal challenges. @jenniferhunter also may have some thoughts to share.

Glad you've gotten to connect with @gently.

What would you say worries you most about recovery, @marcd2k?

@lisalucier Hello, Lisa, thank you for your reply. And also for the combining with other posts, I will be looking at the other replies to see what everyone has said.

The biggest worry I have is that I do not feel I have fully recovered from my first surgery back in November. This muscle cramping has kept me from getting my strength back, and I went from 165lbs down to 150lbs currently. I've lost mainly muscle in that 15lbs, as I was already pretty lean prior to surgery.

Now, if I have a second surgery, and a second 6-weeks of No Bending, Lifting, Twisting, I'm worried about really falling behind in recovering. Especially after a spinal fusion, I do not want to have scar tissue build up to the point it affects me moving as normal as I should be.

@gently Thank you for your reply. It's good to hear you've seen this recovery period. And yes, I'm sure there are more answers on the way.

It is definitely apparent that each individual in this thread has his/her own specific experiences (successes and failures) dependent on processes undergone.
In my case, I had a final chat with my chosen neurosurgeon yesterday (29 June), and I am booked into theatre on 20 July to undergo an ALIF at L5-S1 with a titanium, not PEEK, cage (ordered from here: https://4webmedical.com/) filled with bone material - not from my hip, but from the bone bank - and then, after flipping my body over while under anaesthetic, inserting pedicle screws (titanium rods screwed into the vertebrae) through my back securing stability between L5 and S1.
It's an estimated 4.5hr surgery, but the prognosis sounds best to me, with a shorter anticipated recovery time due to additional stability provided by the pedicle screws.
It's an approx all-in 1 year recovery. Initially, it'll be arund 3 months before more resistive/strenuous physical activities can be entertained, other than physical activities with the physio, including walking.
I can't have a foraminotomy due to the level (L5-S1) affected and my hips being "in the way" for this procedure.
I'll keep this site informed on my progress, but I'd be pleased to continue hearing others' experiences and opinions on the above.
Good health, or best health under the circumstances, to you all.

@profevl Thank you for your updated information. I also had ALIF surgery at L5-S1, but the surgeon did not insert screws. He went in from the front, just under my naval, removed the bad disc, installed the medical disc, and performed the fusion.

I have seen others mention the additional screws being used, but this was never brought up by my surgeon. I am 7 months post-op and my back has been healing nicely. Unfortunately, I have permanently locked muscles in my right side, the oblique muscles that wrap around the hip. This has kept me fro fully recovering, as these muscles go into severe cramps even when using very light weight for rehab. I've been searching for three years and not one of the 30+ medical professionals I've seen can tell me what is happening.

I can't imagine why the right side abs/obliques would lock up @marcd2k. Hopefully I don't have the same after-surgery challenges.
I noted your physical stature, being athletic / lean. I am very athletic at 6'4" (193cm) and 225lbs (102kgs) and intend using this "advantage" in my recovery. I know that my vertebrae are large, so insertion of pedicle screws after the anterior (front-access) ALIF will be "simple".
Keep me (us) posted on how you address yor muscle challenges (other than slowly).