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Journey from foraminotomy to ALIF (Anterior Lumbar Interbody Fusion)

Posted by ProfEVL @profevl, Feb 4 3:17am

I'm being informed that the least invasive LHS pain/ache relief I'll obtain is through having a foraminotomy (L5-S1). High doses of pregabalin haven't worked, and neither has a series of epidurals, nerve root blocks and facet joint injections.

For those who have undergone the procedure, what experiences have you had with the success or otherwise of a foraminotomy? Has it worked for you? Is it "minimally invasive" or actually major? Has the pain and referred aching down the glute, leg and foot been alleviated?

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marcd2k | @marcd2k | Jun 30 12:41am
In reply to @profevl "I can't imagine why the right side abs/obliques would lock up @marcd2k. Hopefully I don't have..." + (show)
Profile picture for ProfEVL @profevl

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).

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@profevl That is the problem I've been having, no one else can imagine it either. I'm on the smaller side, 5' 8", and before my surgery, I was 165lbs. Unfortunately, since I haven't been able to recover, and I'm down to about 150lbs right now.

I'm told I am not textbook, that I'm an anomoly, and too many times I'm told they do not know what is wrong. I don't have pain in any other area, nothing in the groin, nothing down my leg, and nothing in my back. It is all on my right side. So, without the usual symptoms present, they give up. I didn't think that was an option, but apparently it is a very common one.

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ProfEVL | @profevl | 1 day ago

All set.

I am booked in for surgery on Monday 20 July - ALIF plus Pedicle Screws, L5/S1. components ordered from https://4webmedical.com/ by my neurosurgeon.

It's been a journey getting here, but this is the only course of action available to sort out the impinged exit-nerve at this lumbar level to save my left leg.

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marcd2k | @marcd2k | 1 day ago
In reply to @profevl "All set. I am booked in for surgery on Monday 20 July - ALIF plus Pedicle..." + (show)
Profile picture for ProfEVL @profevl

All set.

I am booked in for surgery on Monday 20 July - ALIF plus Pedicle Screws, L5/S1. components ordered from https://4webmedical.com/ by my neurosurgeon.

It's been a journey getting here, but this is the only course of action available to sort out the impinged exit-nerve at this lumbar level to save my left leg.

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@profevl Good morning, thank you for the update. I noticed you are having a different surgery than you initially mentioned when you left you first message here. Your first message stated you were having Foraminotomy surgery, which is usually the removal of bone or tissue to allow the nerve(s) coming from your spine to have room to move. In today's message, you said you are having ALIF surgery, which is a bit different, a little more involved.

My surgery back in November was ALIF surgery, a Lumbar Fusion at L5-S1, the same as you mentioned this morning. My surgery went very well, and it seems almost impossible that someone can not bend, lift, or twist for 6 weeks after the surgery, but it can be done with good planning.

Getting dressed, showering, and having a place you can get off of your feet for a good part of the day are three areas to prioritize. I was told to not stay in bed all day, to get up and move around every one to two hours.

I have a foot stool next to the bed, which is a big help for what you will be shown, the Log Roll, for getting in and out of bed without bending. I also had a small table in the bathroom where I would be showering to hold the supplies the hospital will send you home with.

There are wipes for cleaning the area around the incision, a small plastic tub for washing your face while standing at the sink, and I kept a small trash can on the table so I did not have to bend over to throw things away or change the trash bag.

Please ask if you have specific questions about this procedure, I'll answer what I can. And good luck with the surgery!

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ProfEVL | @profevl | 19 hours ago
In reply to @marcd2k "@profevl Good morning, thank you for the update. I noticed you are having a different surgery..." + (show)
Profile picture for marcd2k @marcd2k

@profevl Good morning, thank you for the update. I noticed you are having a different surgery than you initially mentioned when you left you first message here. Your first message stated you were having Foraminotomy surgery, which is usually the removal of bone or tissue to allow the nerve(s) coming from your spine to have room to move. In today's message, you said you are having ALIF surgery, which is a bit different, a little more involved.

My surgery back in November was ALIF surgery, a Lumbar Fusion at L5-S1, the same as you mentioned this morning. My surgery went very well, and it seems almost impossible that someone can not bend, lift, or twist for 6 weeks after the surgery, but it can be done with good planning.

Getting dressed, showering, and having a place you can get off of your feet for a good part of the day are three areas to prioritize. I was told to not stay in bed all day, to get up and move around every one to two hours.

I have a foot stool next to the bed, which is a big help for what you will be shown, the Log Roll, for getting in and out of bed without bending. I also had a small table in the bathroom where I would be showering to hold the supplies the hospital will send you home with.

There are wipes for cleaning the area around the incision, a small plastic tub for washing your face while standing at the sink, and I kept a small trash can on the table so I did not have to bend over to throw things away or change the trash bag.

Please ask if you have specific questions about this procedure, I'll answer what I can. And good luck with the surgery!

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Thanks, @marcd2k
Three opinions said that a foraminotomy was not possible because the left hip pedacle is in the way - so it's now ALIF with posterior rods.
I know it's the fear of the unknown that's the biggest concern for any of us, so it's great to have people like you providing your own experiences as a guide to what we (I) can expect. Naturally, I trust my neurosurgeon as he operated on my spine a few years ago in an emergency bilateral microdiscectomy when the L3/L4 ruptured into my spinal canal. While he's a few years older, so am I, but he's reputable.
So, being comfortable that the surgery won't be a problem, my immediate uncertainties lie around the first week in terms of surgical pain, ablution/bathroom abilities (a liquid diet in hospital while the intestines re-settle), etc.
It's one day at a time, I suppose. But being prepared helps.

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marcd2k | @marcd2k | 16 hours ago
In reply to @profevl "Thanks, @marcd2k Three opinions said that a foraminotomy was not possible because the left hip pedacle..." + (show)
Profile picture for ProfEVL @profevl

Thanks, @marcd2k
Three opinions said that a foraminotomy was not possible because the left hip pedacle is in the way - so it's now ALIF with posterior rods.
I know it's the fear of the unknown that's the biggest concern for any of us, so it's great to have people like you providing your own experiences as a guide to what we (I) can expect. Naturally, I trust my neurosurgeon as he operated on my spine a few years ago in an emergency bilateral microdiscectomy when the L3/L4 ruptured into my spinal canal. While he's a few years older, so am I, but he's reputable.
So, being comfortable that the surgery won't be a problem, my immediate uncertainties lie around the first week in terms of surgical pain, ablution/bathroom abilities (a liquid diet in hospital while the intestines re-settle), etc.
It's one day at a time, I suppose. But being prepared helps.

Jump to this post

@profevl Yes, you cannot be too prepared. This was my first surgery, so I really didn't know what to expect after the surgery as far as medications and my diet. As far as the surgery itself, it has gone better than I expected, with less pain than I expected, as well.

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jlssurplus | @jlssurplus | 4 hours ago

Good luck I am sure you will do fine.
Since most of the 1st week is in hospital just roll with what they tell you.

Things that are good at home, reacher/grabber tool,

Ice packs:
https://www.amazon.com/dp/B06XBKG542
I bought this 7 years ago and still works fine. Works good for getting in and out of bed, I'm 300lbs and it doesn't move an inch and doesn't damage ceiling. Can be moved anywhere
https://www.amazon.com/dp/B0026IBRTC
If you don't have an adjustable bed they make an air wedge for under mattress that works good for positioning

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