I recently had a back operation in February and only found articles that scared me half to death, so thought I’d write a little on my experience; hopefully to put you mind to rest.
What is an Alif ?
Anterior Lumbar Interbody Fusion (ALIF) is a back surgery that involves approaching the spine through an incision in the abdomen. A portion of the affected disc space is removed from the spine and replaced with an implant. Titanium or stainless steel screws and rods may be inserted into the back of the spine to supplement the stability of the entire construct.
Finding out i needed back surgery
After years of pain and lack of free movement , various x-rays and MRI’s the latest one showed my back had given up on its quest for stability. The surgeon did not pull any punches declaring “you need a back operation” followed up with “we will need to enter through the ffront”. Hold on, i thought, surely its easier through the back, but thinking he wanted a challenge and not wanting to argue i let him finish with “pick a Tuesday” . This got me the most as i then thought he was a) tired on a Monday or b) had not had the greatest success on other days of the week. But, it turned out through the front would allow me to recover quicker and he only performed surgery on Tuesdays, so all was well.
The operation – day 1
I got to the hospital at 7am and was spoken to by the Anesthetist, who had such a calming voice he could have not worried about the drugs. He went all through what would be happening and by 8am i was on the trolley to surgery. At this point i was pretty calm as everyone had been so nice and they had already explained i would be waking up in intensive care. The next thing i remember is waking up with an oxygen mask on and about 7 wires out of me. I of course at this point wiggled my toes and finding all was well closed my eyes for a nap. When i next woke up the nurse was checking the machine readings and offered to swab my mouth with water. Nothing in the world could have been better, it was like nectar and for the following 2 weeks i would drink nothing else (as it just tasted so good).
As i was in intensive care the nurse was with me all the time ( i had 3 over a 24 hour period and they were amazing). During this time they kept on asking about my pain on a scale of 1-4. I kept on telling them 1 (the lowest), which they seemed not to believe and would press my morphine drip every 5 mins; the morphine drip and oxygen are the great bonuses of an operation, i was sad to see them taken away on day 5.
Day 2-5
Once out of intensive care, i just lay in bed, feeling just fine, with very low levels of pain (i had been in constant pain for about 7 years, so this felt much the same or better! also Morphine and vast amounts of Tramadol and Diclofenac must have helped). Over this period i has stupidly expected to be watching TV, listening to music, reading and basically chilling. What i actually did was look out the window at the top of a tree and think that the picture on the wall of a house with flowers growing up it was a monster donkey. I of course made friends with the monster donkey, thinking best to keep on his good side; morphine is a wonderful thing.
Day 6
This was a wondrous day for 2 reasons, firstly i was walking, well going very slowly about 10 yards and secondly the cafetta was to be removed. The cafetta as a great help for day 1-4, but by day 5 i hated it with a passion and its the only thing i remember that caused me any real pain; it went wrong on day 4 and stored over a litre in my bladder rather than in the bag, this was not good at all!
Day 7
Yippee off home at last. To be honest i had no desire to go home until day 6, I felt safe in hospital, but once i figured i could walk i wanted nothing more than to escape. The walk to the car was the longest i had walked and the car was not the most comfortable form of transport; i was not allowed in a car for 3 more weeks after this trip.
Week 2-3
The next 2 weeks were spent in my PJ’s as they caused my scare the least irritation and the day consisted of:
- sit no more than 20 mins (build up to this over 2 weeks)
- walk around no more than 20 mins (build up to this over 2 weeks)
- lie down 45 minutes
- complete the exercises given
- repeat it all again
As you can imagine this is not that exciting and for the whole of week 2 i was so drugged up i did nothing else. The pain levels were just fine though and the strength was building.
Week 3-5
Weeks 3-5 was much the same as 2-3, but building up stamina and able to function mentally as the drugs were much reduced by this point. Also at week 4 i was allowed in a vehicle and after 5 weeks feeling trapped it was a great feeling to get out
Conclusion
Don’t worry about the operation and do everything your told; the exercises feel impossible to begin with but get very easy, within weeks. My back is the best its been in years, it aches a little but after only 4 months i have great movement, endurance and have minimal aches and pains; apparently it takes 2 years to heal completely but i should be playing tennis again in 2 more months 
{ 21 comments… read them below or add one }
Wow – I never realised that the “pick a tuesday” procedure and recovery was so complicated – you are very brave mate, very brave indeed. I have never had a catheter fitted but I had something similar when I had a salivary gland removed and its removal was more stressful than the operation itself!
Hope all is well and look forward to seeing you soon Mark.
Mark,
Thank you so much for posting this! I am going in for ALIF surgery this Friday, July 30, for L4-L5/L5-S1. I am so glad to hear you are doing well and to see something that wasn’t posted in 2005. I greatly appreciate you sharing your recovery with us!
Thank you,
Sandra
well ii was worried about the operation,people you have had it have said they are ok,but some people keep saying don’t have it what do you do ,i got to have 3 disc and 2 rods fitted not looking forward to it at all..
I agree it’s not something to look forward to! but it changed my life for the better in so many ways. I wish you good luck/ a speedy recovery, whatever you choose to do. all the best, Mark
Thank you so much for this detailed description of this procedure. I had my husband look up this procedure on the internet from the fear I have of having it proformed. I am so scaried that I was even thinking of canceling the procedure inspite of the pain I have endured for over fifteen-years. I am having mine done on January 3rd of 2011. I am still very scaired. I am having the L-5 area done. Thanks again for your help and helping me to calm my nerves some.
I had the L5 area sone and this was the first christmas in many that i managed to sit in a chair for more than 15 minutes without having to get up and move around. This year i say for hours and while i have a few aches , there not worth worrying about. I Hope, that you have the same success.
Thanx to all for sharing. I have an annular tear in the L5S1 with disc bulge as shown by an MRI. I have hip and leg pain which was severe before I began gabapentin on top of diclophenic and with some amytryptyline. I am following my physio exercises to build up core strength and walking on a treadmill. I must wear a very stiff pair of spanx shorts sometimes these plus a lumbar support belt to walk on the treadmill or walk at all. It has been almost 9 months since the initial injury. I am interested in hearing positives about surgery and appreciate that it is a very tough thing to come through. There is no pinching or compression of the sciatic nerve according to the MRI.
I had the ALIF procedure 6 months ago on the L-4, L-5,S-1 and it has been the worst experience of my life. The first week after the surgery I was in horrible pain and had to constantly take narcotic pain meds like percocet. After 6 months I am in worst shape then I was before the surgery, and still have to take the pain meds 2-3 times a day. There is a percentage of people, about 30% I believe, that have my experience….aren’t I the lucky one. My doc says it could take up to year to heal properly. I am trying to stay optimistic and pray I will eventually get out of pain.
i have to do a surgery on my L5S1 , but kind of optomistic about it i have a herniated disc with constant pain is there anyone who had that surgery before and how is it.
I am nearly a year out of surgery, my anniversary is the 8th Feb. I spent many years in pain and could not walk properly at the end and i must say surgery was the last thing i wanted. I had the surgery and think the key thing is to do everything they tell you. I complete the set of exercises (the hospital pysio gave me) every day and try to swim at least 3 times a week. I also resist the urge to lift anything remotely heavy (over about 10kg) and fingers crossed all is well.
My back aches every day and still feels a little weak, but i hardly notice it and it has no real effect on my life. Bill who also replied has had a much different experience to me and it is fair to say you are just playing the stats when you have an operation, but try to sway them by doing everything right. Good Luck. I think i will write a long post on my last year and te few glitches in the next few weeks.
Hi Bill, i am sorry to hear your experience has not been at all good. I wish you every success in your recovery. Mark
I went in for a 2nd opinion yesterday. Both agreed I needed Back surgery. My Dr recommends ALIF. I have L5S1 and L4L5, with moderate to severe stenois at the L4L5 and severe stenosis on the L5S1. I could live with the back pain if I had to, but the numbness and loss of feeling down my left leg and foot, seems to disable me more.
My Dr says I should only be out of work 2-4 weeks, since I have an office job, but from all I’ve read, I think I would need more recovery time. Thank for you article.
I started to work from home for some half days. Then half days at home mixed with half days in the office (i had to travel over an hour to work). This worked well for me and gave me confidence as i pushed the limits; as you do tend to worry about every twinge for a while
all the best, Mark
Hi Mark!
I’ve been Googling for testimonials and stories, I guess I have been looking for a virtual “support group” to ease my worries about my up and coming double surgery…;) I just got my admission date today, it’s 12th Oct. It will be less than 4 months since the initial consultation with surgeon so hooray – he wasn’t lying when he said it will be quick!
I’m 36 yrs old and guessing you are not that much older yourself…? Been suffering for 3 years and will be having an artificial disc replacement for the L5/4 and ALIF for S1/L5. So feeling nervous. But also relieved because the last 6 months have been extremely difficult, and currently I can work just about 3 days a week because of the pain. I have of course been through years of physio, am very active and fit and have always eaten healthily. I have also tried chiro, acupunture, ostheopath et al.. so obviously, like anyone in a similar situation, surgery truly is the last resort.
One thing I would say though; Pilates is the BEST thing for anyone suffering from similar chronical back pain. I do it every day, twice a week go to classes and rest of the days just at home. Sometimes I cry because of the pain (and stop there of course) but once I learned the “language” of Pilates I am sure it has strengthen my core and helped me to understand the complexity of my body and my problem.
It was good to read your story and about the days and months in recovery! Great to hear you are doing so much better now, and feel that you have got a great part of your life back. Do you think you could tell me who operated you…? You can use my e-mail for that, and it’s fine of course if you don’t want to share it.
I will send an up date post-op, fingers crossed all goes well! Best, Matleena
Oh and morphine – yes it’s wonderful. I had a discography test in April to find out more about the problem and after the procedure I was experiencing pretty severe pain, but was given morphine — and so I was dancing with jelly babies on cotton wool clouds….
(Hard to imagine anything else would ease the pain post-op as I am already using Co-dydramol and Diclofenac on my worst days/to get some sleep at nights and like today, they don’t seem to work at all…)
Thanks for your posts. I am going in for ALIF on Thursday 13 Oct and feeling quite nervous about the procedure. Have been suffering for several years, and had many steroid and epidural injections with basically no relief. Had a cyst on the nerve removed last year, but still struggling with daily activities. Have also tried accupuncture and various meds. Been very active with physiotherapy and doing 2 classes a week and more at home to build up my core strength but still can’t do much that requires any physical effort. Have to lie down for several hours during the day to be able to cope with evenings.
At this stage, want the surgery behind me – what ever pain I have after the surgery, my hope is that it will eventually reduce and allow me to function semi normally. At the moment I have pain and no end in sight.
Thanks again for your posts – it has helped me to feel a bit positive about what awaits in the next few weeks!
p.s. I am in Sydney Australia – anyone else from our end of the world?
Wanted to give you all an update. It is just over 2 weeks since I had the surgery and I feel really good.
The first day was spent in ICU with a 24hr nurse and I was attached to many drips/drains/pipes – not exactly sure what. I also had a cathetar and Morphine drip which I didn’t even use that much.
24 hours after surgery the Physio took me off the bed and that was a bit difficult, but managable. A few hours later I was moved to a private room and the cathetar was removed. I had a drip and was drinking quite a lot as my mouth was very dry. I felt I was going to the toilet every hour or two, till they eventually removed the drip after the 2nd day. My mouth was very dry for a few days and my lungs had collapsed a bit from the tubes I had during surgery, but really wasn’t too bad. I had a pain machine in my stomach when I came out of surgery and hardly felt my cut except when I needed to cough or sneeze. I was given a rolled up towel to hold on my stomach and that helped. Over the next few days I started eating, although very small portions, and thankfully my stomach worked fine after about 3 days. I have had some numbness in my lower back, but no-one seems worried about it.
I have been home for over a week now, and try be upright as much as I can. I go for short walks up and down the street but find that I also sleep a lot. I haven’t really done much around the house but will start doing a bit more in the next few days.
Hard to tell how much relief I have from the surgery because I am still resting a lot, but I definately don’t have the clicking pain every time I sit or lean forwards etc. so at least I know some of my pain is gone. I was so worried about the surgery and relieved that it is behind me, and in retrospect, it wasn’t quite as bad as I thought it would be.
In about a week I am allowed to drive short distances, and then in 2 weeks time, I see my surgeon again, and he will then send me for physiotherapy. At this point, he only wants me to walk.
Good luck if you are planning on having this surgery. It has been amazing for me, and I hope you have as good a recovery.
Thanks for the post, really glad its going well for you keep on doing all the exercises its been 18 months for me and i still do them all twice a day. Its a bit of a chore, but it keeps the core strength up. Mine always goes through achey phases, but if i keep up the exercise and occasionally take a few days worth of meds i am back to normal. I am thinking of making an update post on the last year soon
keep on the mend, Mark
I really appreciate all the posts. I am going in for surgery tomorrow (L5/S1). I am a little nervous but your posts really help. I will update and let you all know how it went. Currently they say I will only be in the hospital over night!
Hi, i hope all has gone well and you are home for new year. Try not to focus on every pain in your back and legs, i sometimes do that even now (its been near 2 years). Keep positive and if you do have any pains set a time a month in the future to re-evaluate, rather than evaluating progress every day; as its obvious things don’t change that quick.
Just an update. I had my surgery on 12/29/11. I only stayed in the hospital one night. The first week was pretty tough, but I have been steadily recovering ever since. It has been almost three weeks now. I was back at work in 12 days! It has not been easy, but I know it will be worth it. The hardest part has been not picking up my children. I have a 2 1/2 year old and a 6 month old. Hopefully at my next appointment the doctor will up my weight limit so that I can pick up my baby!
Thanks again for all the posts. Having read other’s experiences really eased my anxiety about the surgery. Like I told the surgeon, I had it easy. All I had to do was sleep!