L4-5 ALIF - YOUR HELP PLEASE

Here I am on yet another user forum after surviving cancer in 2007 & 2009 and a couple of heart attacks sandwiched in between (2008 & 2010).  All of the surgeries and recoveries having to do with the prior issues in my health history were made easier with advice and insights offer by other regular folks going through the same thing.  I am hopeful that remains a truth as I now face back surgery to repair at least one problem and possible as many as three.

Apparently the most urgent issue is a "bone-on-bone" problem at L4/L5 that is infringing on the nerve root and causing some pain. However, to be honest and from my point of view, a problem with my neck is much more irritating and described in the radiology report as:

CERVICAL DISC LEVELS:
==============================
C2-C3: No significant disc/facet abnormality, spinal stenosis, or foramina stenosis.
C3-C4: Mild disc degeneration with minimal uncovertebral joint spurring on the right. The central canal and foramina are unremarkable.
C4-C5: Mild disc degeneration with mild bulging of disc material out laterally into both foramina. Mild
uncovertebral joint spurring contributes to mild bilateral foraminal narrowing. Small annular
fissure defect seen along the posterior disc margin on the right.
C5-C6: Mild annular left-sided disc bulge narrowing left lateral recess. No spinal cord or exiting nerve
or sleeve compression.
C6-C7: Mild left posterior disc bulge C6-C7 narrowing left lateral recess and slightly compressing
exiting left C7 nerve. Right foramen is clear.
C7-T1: No significant disc/facet abnormality, spinal stenosis, or foraminal stenosis.

CONCLUSION: Mild left-sided disc bulge C6-C7 narrowing left lateral recess and foramen and
slightly compressing exiting left C7 nerve.


My surgeon - on the other hand is very concerned with the lumar report and wants schedule surgery as soon as possible:

LUMBAR DISC LEVELS:
===============================
L1-L2: Mild disc degeneration. The central canal and foramina are unremarkable.
L2-L3: The disc, central canal and foramina are unremarkable.
L3-L4: Mild disc degeneration. Disc material bulges out laterally into both foramina without exiting
nerve or sleeve compression. The central canal is clear.
L4-L5: Severe disc degeneration and narrowing. Marginal osteophyte formation narrows both
foramina with slight encroachment upon the exiting right L4 nerve. The more significant
narrowing is on the right. Mild bilateral facet joint degeneration
L5-S1: Mild disc degeneration with minimal annular disc bulge. Mild bilateral facet joint degeneration.
The central canal and foramina are unremarkable.

CONCLUSION: Severe disc degeneration L4-L5 with mild secondary osteophytic spurring
narrowing both foramina. There is mild encroachment upon the exiting right L4 nerve.

The L4-L5 severity seems to be the driver and he (the surgeon) seems to think realigning my spine with an ALIF will help the Cervical issue without surgical intervention to the neck area.

I do not have a great deal of intolerable back pain most of the time - saved the few of times a year when I twist or strain an end up in bed for a week with medication, cursing the world and looking for a fix. I do have trouble sitting for periods of time then trying to get up and getting out of bed each morning is a process that takes some time with significant lower back pain.

Still, I feel the back pain is somewhat manageable - albeit with massive doses of Vicodin (5x 5-500 on average daily)

The neck pain leading to incredible headaches is another matter.
I chew Vicodcin like candy all day just to keep it in check and use Valium at night to relax enough to sleep.

I am 56 - slightly overweight but not too bad (5'11" @ 240lbs) - nonsmoker, non-drinker other than an occasional beer or two.

Anyone out there faced a similar decision and willing to share advice and outcome?

I am also very interested in input concerning ALIF L4-L5 Fusion recovery time and post-surgical pain?

What is the worst case scenario if I do nothing?

I am also concerned as to the odds of a succedssful outcome given all the chemo and heart meds I have been subjected to - most significantly Plavix.

The neurosurgeon is very insistant that surgery is a must and that - in and of itself - has me concerned.

Thanks to all that take the time.
Thank you all - very much.

RB

[jalonso]

Hi there I'm sorry you are going thru a hard time. I had the alif l4/5 and l5/s1 a little over 2 weeks ago. Nothing like I expected. I was in hospital 6 days had a problem with blood pressure dropping due to the pain meds. They have me on percocet and soma every 6 hrs along with laxatives and stool softeners they will be your best friends try to avoid constipation at all costs. You'll find the pain to be different than before surgery. I had a lot of nerve pain that was gone day after surgery now Dr said surgical pain. Your belly will hurt especially when you cough laugh or sneeze. Your back may feel very stiff. I have found must haves for home recovery a hospital bed if you can get one bars make it easier to get in and out of bed and great when you can raise your head and legs. A grabber ask Dr for one they gave me in hospital nothing worse than dropping something and not being able to blt bend lift or twist. A raised toilet home toilets very low to ground very hard get up and off of it. Wear your brace when your out of bed I forgot it one morning while going to rest room and my body wad angry for 2days lots if pain. Hopefully you have someone home to help out since you'll have so many restrictions I have found those to be the worst of the alif. Lots of patience remember your body has gone thru a major surgery and requires a recovery period for fusion 3 months to a year. Lots of days you are frustrated because your basically in bed out to walk sit a little and that's it. You may also need a walker everyone is different with this type of procedure I have found the hospital staff to be great and really cater to every individual patients needs. Good luck to you I wish you all the best for a fast recovery.