Scheduled: Anterior Lumbar Interbody Fusion (ALIF). What to expect?

Hi i go in soon for this surgery ive been cancelled around 6 times but surgeon said it'll be any day

Hello John, I just had lumbar fusion surgery (ALIF) at L5-S1 in November of 2025, so about 4 1/2 months now. The disc at the L5-S1 area had collapsed on the right side, so it was removed and a spacer inserted, then the fusion around the spacer. I was actually surprised at how little pain I had in my lower spine after the surgery, however, I have developed another problem.

My muscles on my right side, obliques, abdomen, and flank areas, are constantly locked. This is causing pain whenever sitting or standing, and the only relief I get is laying on my back. It takes about 10 minutes of laying down, and everything relaxes. I had another image done after the surgery, and there was nothing conclusive showing what was causing this muscle issue and pain. The doctor tried an Epidural at T11-T12, because after the image was looked at by two doctors, they said it was worth a try. Well, it was not worth the try, because after a month from having the Epidural done, I am in more pain than I was before the Epidural. This is from when I get up until I go to bed, with, as I mentioned, laying down the only way of relieving it.

So, the fusion surgery corrected the L5-S1 disc collapse, however, I am still looking for someone familiar with locking muscles on one side with no relief from any medical procedures. Good luck!

Even with PT and dry needling?

Hi, I had ALIF surgery on L4 & L5 on Sept 10, 2025, just about 6 months ago. Not at Mayo, but by another excellent surgeon closer to my home in northern MN. It was a success!! As far as recovery goes, ice packs and judicious use of oxycodone are your best approach to managing pain. Your abdomen will be 'puffed up'! I was amazed at how much my tummy had swelled up, but of course to be expected, as the gastro surgeon had to 'dig around' in there to move things around to access the spot where the spine surgeon was going to put the spacer. Yes, it's sore for awhile, and you'll want ice packs on your abdomen to reduce the swelling. Your tummy will return to its pre-op shape in a few weeks. In the meantime, expect a little 'gurgling' going on down there while your intestines get back to normal. Also, I would highly recommend eating lighter and drink plenty of water to make this easier on your body. Avoid carbonated drinks; your tummy will thank you. As for your back, you'll want ice backs on your back where the incisions were, to relieve any swelling and pain. I had ice packs front and back for around 3 weeks, on a constant basis. I also limited myself to 2 oxycodones per day: one before bedtime to help me fall asleep and relieve the pain, and 1 in the morning for the same. (Oxy made me drowsy, so I'd take a nap mid-day, but you need the rest to heal!) Also, I slept in a power recliner which was FIRM and supported my back, and I could adjust the recliner's back at just the right angle for sitting or sleeping. Much better than the bed! Also, the power recliner could also tilt forward to aid in getting up from a sitting position. I highly recommend getting or renting one of these recliners....they are well worth the money, and you never know when/if you'll need it again, for whatever reason. One more thing to help recovery: a toilet riser to fit on the toilet seat.(available from amazon) So much more comfortable, not very expensive and easy to install and remove. Get one with handles on it which makes it more secure for you to get down and up from the potty. And last but certainly not least: Think positive! Your body will take time to heal from the surgical procedure---be kind to it, take all the rest you need. Spine surgery is a very delicate, serious thing---let your body have plenty of time to recover: don't rush. Despite the post-surgery pain, I was so happy with the outcome because I remembered the absolute agony I endured pre-surgery with one vertebra that had slipped over another one. At 6 months post-surgery, I am not doing back-flips or bronco riding, but then again, I didn't do those things before surgery, either! (I am 72, btw) My 'physical therapy' consists of climbing stairs, walking (careful not to slip on slick sidewalks) and just doing daily activities. For a few months post-surgery, you will be restricted to no 'BLT's'---Bending, Lifting, Twisting. No heavy lifting, more than a gallon of milk (about 5 lbs) I declined PT appointments which I didn't think I needed, and so far, so good. Best wishes on your surgery!!

@northstar25
Very informative and encouraging! Thank you!

@northstar25 Thank you for the comment on your surgery. I’m going to have a similar surgery in November. L3 through S1. I am worried about my recovery and if I will be able to walk and do things similar to before the surgery. My surgeon is wanting to do an ALIF procedure. And then go in posterior to put in some rods to strengthen my back. I am worried about my flexibility post surgery. I am also worried about it the expedited breakdown of the L2 L3 joint over the next several years because of increased wear and tear due to the spine being fused. Let me know how things work out long-term. Thank you for your post.

@cancerkicker My experience has been positive in regards to flexibility---although I admit I am not 'athletic' ---I don't play pickleball, go jogging (Double knee replacement in 2020), bronco riding, backflips, etc etc. My daily activities include climbing stairs (multi-level house), doing household chores, a bit of gardening, and the like. I will say that I can bend from the waist with knees slightly bent, with no pain but I shy away from twisting as I am very cautious about putting too much strain on any hardware or adjacent vertebrae. I also don't do very heavy lifting. My L4L5 fusion , via ALIF, was because one of those vertebrae had slipped over the other. It was a tricky surgery, because my lower spine had a 90 degree angle to it---the docs had never seen one like it! So----I am doing great so far, 10 mos post-surgery. I can walk without pain, which I was unable to do a year ago. I remember well the agony I was in last summer, and I want to preserve the fine work my surgeon did to get me back into shape. I am almost 73, and I don't want to have to do a 're-do' on my back (or knees) because I did something silly like pretend I'm 25 years old again! I am so very happy I had this surgery done, my surgeons were fabulous, my hubby was great with providing lots of ice packs post-recovery! I didn't do any 'physical therapy' simply because I felt I didn't need it with my daily activities. I wish you all the best with your surgery, don't be fearful, think positive and just be kind to your body! Btw, I am a cancer-kicker also.

Thanks for the encouraging reply. I am 66. Hope ro be able to take long walks post surgery. I also enjoy bike riding and motorcycling. I farm so my work is quite active. My L 5 has turned about 15 degrees. L3L4 are rubbing together