Anterior Lumbar Interbody Fusion (ALIF) – Back Surgery

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


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 🙂

87 responses to “Anterior Lumbar Interbody Fusion (ALIF) – Back Surgery”

  1. 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.

  2. 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,


  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

    • 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 am having the exact same surgery as you, and I am terrified.
      I just weaned myself down to 10MG of oxycodone, which took almost a year, considering all the meds I was on. To now know, I will have to do that all over again is very daunting.
      I do not want this surgery, I NEED it.
      I have exhausted every other conservative treatment including hands on osteopath.
      I am down to “bone on bone” and every lumbar disc has been bulging for over 19 years now.
      Living on an ice pack in a reclining chair is no life at all.
      I am an unreliable volunteer, since I am on disability.
      Volunteering from time to time, made me feel emotionally better, but it was subject to if I could walk that day or not.
      Thanks for being honest. This whole thread was pretty positive, until I found your exact surgery, that coincides with what I will face.
      He showed me an artificial disc he will be installing.
      Do patients bodies reject artificial discs?
      Does anyone have any knowledge on that?
      I wish I could go to Germany where they are 7 years ahead of the US on discs.
      Their discs more resemble “breast implants”. Very squishy and more like an actual disc.
      The US has titanium or a plastic-like material.

      • Do patients bodies reject artificial discs? i very much doubt it as there is no biological material used.
        I wish I could go to Germany where they are 7 years ahead of the US on discs. I looked at all the options and was told that some of the newer tech, may look good, but is not as well tested under real conditions as the older tech. But in the end I had the ALIF, just a fusion of discs, which restrict the movement (very slightly, i can’t notice as i was in such pain before). the Key thing is I felt so much better 18 months after my op than before, I felt like my life had started again. It sounds like you are in such a state, i hope it all works out well for you too. tTy not to worry and the key thing is to do every exercise they tell you. I still do mine morning and night (without fail) and its been over 5 years soon.

  8. 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.

  9. 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

  10. 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

  11. 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…)

  12. 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?

  13. 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.

  14. 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

  15. 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.

  16. 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!

    • I am one week out L4/L5 ALIF – found not being to pick up my son the worst/most emotional part. Being a mom, I can handle the pain…But not holding my son is intense.

  17. Another update. It’s been over two months since my surgery. 100% of my original back pain is gone! I still hurt from the surgery but it’s getting better every day. I even played paintball with the teens from my church for hours on Saturday! It was definately worth having the surgery. I am back swimming, but running may take a while. Thanks again for everyone who shared their story. It really helps those who are faced with having this surgery to hear someone else’s story. God bless!

  18. Hi – gr8 to see there are more success stories than failures ! – am due to have a L4/5 and L5/S1 ALIF in the next month or so (waiting to meet with the vascular surgeon first) – my surgeon advised me that recovery is a lot quicker with ALIF than the alternative posterior procedure leaving the decision up to me. I have been in pain since Jan 2011 and it has progressively got worse – to the extent of requiring the op. I do a lot of running and weight training which came to a stop about 4 weeks ago and am currently off work (and in nearly constant pain) – would be interested to hear from anyone who ran a lot prior to the operation and how long it took to get back on track…can’t wait for the op so I can get into recovery and start living my life again !!! Don’t know what people do when they retire; there’s only so many books you can read !!

  19. It is now about 5 months since my surgery and I feel fantastic. I still have minor aches and pains, but I am functioning quite normally. I still limit how much I will lift, and am careful about over doing things. I can sit comfortably for about an hour, and then have to have a bit or a walk around, which is not a problem at all. Just need to make sure I sit on the aisle at shows and movies. I have weaned of the Endep I was taking for nerve pain, and currently am only taking Celebrex, but will be starting to reduce that in the next few weeks. I do a physio exercise class twice a week, and try walk at least once or twice a week, and I think it is important to keep moving.
    I was on so much medication the year before my op that I have serious memory lapses from the past year. Now my only problem is that I am struggling to shake off the weight I put on (probably due to the Endep). My stomach is still a bit tender when I do exercise and try to lie on my stomach on a ball, but otherwise it feels quite good. I was having a sleep every afternoon(another side effect of the Endep) but thankfully I am now able to cope without the sleep, although I do sometimes have a lie down just to take pressure off my back a bit.

    Good luck for your op Doug, hope you get the great result I have had.

  20. dont know what to do? went to see the neurosurgeon just today he suggested ALIF surgery,I have had burning sensations in the tops of my feet for over a year had a lot of test and then finally an MRI which led me to the neuro which is when he said my L5 is collapased and suggested this surgery.I now feel alot of pressure n my back I have been seeing a chiropracter 2 a week,but from what the surgeon said that kind of treatment including physical therapy,accupucture will be something you will do for the rest of ones life if you choose not to have the surgery HELP?

    • Hi, I had my problem for 8 year prior to surgery, I used to visit the physio or osteopath every 2 weeks during this time; yes it was expensive. I visited the surgeon four-five times over this period and had MRI’s. It was only on the last visit he said he thought i should go for surgery; his advice to me was to hold off and see if it rectified itself , as the back naturally collapses and surgery is no guarantee. Only you know how bad your back is, I held off until I could not walk, that may have been a bit to long!

  21. Hello, Mark and all others. This website page is the first genuinely useful one I’ve found. I wrenched my back whilst flying a Boeing 757 but kept working in the vain hope that I could cope and have been finally sent to have it fixed with ALIF after the CAA revoked my medical. The 20+ sessions of physio didn’t do much over the last year and the legs have been getting more and more numb. S1/L5/L4 all being fused and the MRI shows L5 protruding forwards.
    Glad I paid out for medical insurance! Hopefully going ‘in’ sometime next week in Cardiff.

  22. Going in for my surgery end of June. I have been looking for comments on this surgery and was glad to have found this one. I have already had one back surgery ( thru the back) 8 yrs ago. Now pain is across lower back, down left leg a nd numbing of toes. Dr. Recommended this type surgery and i was quite concerned about recovery, etc. thank you for your comments as I do feel better about it from all your information.

  23. It’s been about 6 1/2 months since my surgery. A few months ago I started working out again! I have found that swimming is the greatest therapy for recovery. I am fully supported and can still work out. A month of swimming and I was back to weight lifting. Of course I have to be careful, but now I can do most of the exercises that I used to do. I still have some pain and weakness especially getting up after laying for a period of time. Once I get moving I feel great. For a while I was a little depressed thinking that I may have made a mistake with the surgery. Of course I really had not choice. Now as long as I work out I feel great. I have lost 17 lbs and feel great. 25 more to go. Stay positive and stay moving, you will heal.

  24. I am going in for the fusion surgery on Monday July 30, 3012.
    I fell off a ladder in 2008. I have put it off for fear of it not being successful. I am so tired of the pain waking up in the night and then putting a smile on my face just to get through the day. I am scared to death hving this done, I was wondering, I have been told different things, one was that theyb were going through my stomach and then my back for the plate with four screws, can this be true? I am also concerned about getting off the drugs I have been taking, neurotin , Tramadol and vicodin, and ambian if neccesary. Is it easy to get off this stuff, or will they give me something else to help for pain.
    I appreciate all the comments left on here. I am encourage, i moved here to Uyah from California to enjoy the great outdoors. I have done nothing but work come home live on a heating pad and get up and do it again. I am 47 and feel like my life has definatly changed as I know it. Talk to me someone… And I was also wondering do they do the epidural? Thanks.

    • Hi, firstly good luck for monday. Mine was through the front and i have a plate and 6 screws; all very exciting on the X-ray. I had lots of morphine in hospital and then back on the tramadol etc. I must say i did not have to much issue getting off of the drugs, i just kept on cutting them down like they told me to. The key things is to do the exercises they give you; i still do them every day (2 years later). Hopefully like me having the operation will change your life for the better, it will take time so don’t panic (like i did) when i could barley walk to the end of the road after 2 weeks; i can now walk as far as i want. Finally as far as i know they don’t give an epidural as you will be out like a light for a good few hours and then dosed up with morphine. Let us know how you get on, hope fully a story of the great outdoors, in the not to distant future 🙂

  25. Hi, I am wondering if ZM (or Ziva Moss if this is also you). If you are still out there. I am also from Sydney and wanted to talk with someone who has experienced the lumbar fusion operation from my neck of the woods as I have been told I need to have it. If you are still viewing this forum, please try to contact me through this forum.

  26. Hi
    Yes Chris, I am in Sydney – Eastern Suburbs. Have you seen any of the Neurosurgeons? I saw quite a few. Happy to chat privately – not sure how to go about it. Will check this forum regularly

  27. Hi all, thanks for all the positive info and outcomes, I have been waiting 3 years for an ALIF to L5S1, following failed decompression surgery in 2007. I originally fell down the stairs 10 years ago and reached the point where I could no longer walk so had no choice but to have the original surgery as lost use of my right leg. ( am a Physio so surgery for me was major). My main concerns are pain relief after the op, because I am on morphine, amitryptiline, baclofen, naproxen and paracetamol and have been taking opiates for past three years, and my tolerance is really high, so hoping I get adequate pain relief post-op, what do they give you? Am also worried about exercise afterwards cos can’t do any at the moment, does the op bake such a difference that you can walk and exercise without pain and problems afterwards? My surgery is next Tues, 4th Setember in Leamington Spa
    Kind Regards

  28. Wow! Thanks Mark for getting this chat site going. I too have been looking for the best answers on ALIF recovery, as I will be having surgery for L5,L4,S1 on Sept. 18. I have had back pain for about 6 years now, and I find myself lying around, on disability from an 18 year job, can’t walk far due to my right leg giving out, and in pain all the time. Listening to several people talk about getting disogram, or other shots in there back… OMG!! One time I had 13 needles in my back to kill the nerves… That was just on one day..Didn’t work… I pray I am as lucky as you, and have the relief as you did after your surgery. I’m just so tired of pain, and I take oxycotin and perocet. I hope that doesn’t make it harder to relieve the pain afterwards??? Anyways, it’s been nice to have a place tp share where people understand. Thank Tammy

  29. Hello Zm and Chris, iam also from Sydney and looking At doing ALIF soon, I did so much research into this matter and iam convinced that , if it suits your body, then the ALIF is much more superior over the posterior fusion and with much less possibility of future back pain due to screws and rods inserted in the bones. I would love to talk to you and exchange some information about Sydney neurosurgeons and who did it for you.
    My e mail is

  30. I have been putting off surgery for years also. I have had problems with drop foot on my left side along with my extreme lower back aching. My brother has permanent drop foot from nerve damage. It is at the point now that nothing seems to help. I can’t take long walks anymore. I can’t stand for very long and I have to be careful of lifting and bending. The neurosurgeon first suggested XLIF and then switched to ALIF. It kind of scared me but the comments have put my mind at ease somewhat. I am looking at having surgery at the end of October or fist of November. Wish me good luck. Thanks for all of the inputs. Hope to read more success stories prior to my surgery.

    • Good luck, it made the world of difference to me, every day i do things that i could not do before. I very much hope you have the same result, Mark

  31. Hi janet good luck with your surgery , I guess at the end it comes to this equation: pain and struggle with back problem against fear from surgery, whichever bigger wins .so many people did this surgery and it gave them thier life back and stopped thier suffering

  32. Hello Mark,

    Hopefully you keep feeling better mate, thanks for sharing your story with us, it gave me great hope and optimism.
    Got question about your surgery, did they use artificial bone craft or your bone? If its your bone was it painful or no difference to the surgery incision? Feel free to e mail me directly if you wish.
    Thanks again and all the best

  33. I was worried about a bone graft but they said there was no need and they used the artificial bone. Seems to be holding together. It takes 2 years to get to full strength as your own bone grows through. I am going through some aching the last few weeks, but have had it before, so lets hope all is ok 🙂 hope that answers your query.

  34. Hi Ppl.
    i was glad to find the page, And after having a read im feeling much better.
    Im 34 from the hunter valley N.S.W Australia.
    and looking at having the ALIF for L5 / S1.
    ive already had a lamenectomy im oct 2000 and my specialist has given me the 365 days to make the decision but after the last 5yrs of constant and worsening pain im thinking im ready to give it a go.

  35. Hello Dave,
    good luck mate, it’s very hard decision, iam like you looking at having the same surgery and iam a bit older than you, there are few doctors in sydney that does the ALIF, iam from Sydney, ALIF for most people is the best option for fusion for L5 S1 , if you wish send me an e mail on my email address in my previous comment. Maybe we can help each other through this journey.
    Take care

  36. Hello Mark,
    Thanks v much for the info,sorry I didn’t reply earlier, how are you feeling now, hopefully those aches nothing too serious.

  37. Glad to hear of good results from the ALIF. I am scheduled Dec 3rd for L4L5S1 fusion. I have been experiencing severe leg, back and groin pain. I was wondering if anyone experienced any groin pain along with the back and leg pain.
    I was an avid jogger and have not been able to jog, exercise anything for approximately 1 yr. I am ready for relieve. the pain is terrible and limits my work abilities.

  38. I’m 43 and have had back pain for 15 years, it comes and goes and out of no where, it comes! I have a herniated disc and a few bulging S4,S5 area. I have put off surgery for many yeaars thinking it would heal itself but at least every other month I’m bed riddened with the pain for a day or longer. My doctor told me that this fusion surgery is the only thing left to do…I’m scared as I’m very active and want to be able to do the same things…horseback riding, snowmobiling, motorcycling….is it possible to get back to my normal life after the surgery? It sounds so invasive?

    • Hi Jennifer, wow that’s some great stuff you do (even with the bad back). When i asked my surgeon about skiing he answered ‘life is for living, so why not!’ and while i’ve not gone skiing again yet (as my back feels good and i am scared of regressing in any way) i am considering it. What i would say is that it took a good year before i got confident and felt solid, now after near 3 years i feel really strong. But, as i remember the pain, i may not do any of the activities you listed, but i do feel as if i could. All the best, Mark

  39. I am so glad that I found this site. it has helped me alot in knowing that i’m not alone in this journey. at times i was so afraid of getting surgery done , but then with all the pain and lots of things i slowly not being able to do scared me more then the surgery. I had the alif done on 5/31/12 and for the most part I am glad I did it. I still have pain and stiffness which the doc says is common in some people . I’m a little older than some of you folks that have had the surgery so it may take a little more time for me to heal . Just can’t wait for the light at the end of this tunnel. one day at a time with slow progression. I will check in later . best to all that are going to get this surgery done. always get a couple of consults before doing any surgery. then you will know when you are ready for it.

  40. Hello Anita , wish u all the best with the progress. Iam trying to make a decision to do AILF but so far couldn’t do it. I have enough pain and limitation but still couldn’t make the call and very much
    fear the surgery . How did u manage to convince yourself to go and just do it? How did u deal with fear from surgery ? Anyone please feel free to share your experience
    Best of luck

  41. Hello Mark,
    How you doing? I had a chat with my doctor about one of ALIF issues which is the adjacent joint desease, that’s when joint above or below the fused joint get affected and might need fusion after years. I am interested to know what was your doctor opinion about this matter.
    Take care and all th best

  42. IThat is what i was told and it can be true. However, i could barley walk at times and was in a fair amount of pain. I took the opinion that any amount of years it lasted would be better than none. Also my Surgeon said it may well never happen (or it wil do it naturally with age), hence i do back exercises religiously every morning and evening and also swim 3 times a week. 3 years so far, so fingers crossed i won’t need any fusion for a while.

  43. Yes hopefully you wouldn’t need it. One thing you didnt expand on in your description of the surgery and that is how did u deal with your worry and anxiety from th surgery in the few days leading to it? U mentioned that you did read few articles that scared you half to death that’s why I assumed u were worried fom the surgey. And I my self going through this now and appreciate your insight into this side of the story.

    • Good question, i should say it was 3 years ago now. But, my recollection was that i felt more anxiety in the days proceeding the operation than the day i went in. I was lucky in that i made a point of asking for the first slot of the day, so not to have to wait around and get delayed; so i arrived at 7am. They where all so nice at the hospital and the surgeon came in and introduced himself and the anaesthetist (who had the most relaxing voice), shortly after i was being wheeled to surgery. In the prep room they talked me through everything they were doing and what lines i would have in me when i woke up; that was very good as i had about 7 lines in for one thing or the other and it would have been a shock (so do ask). After the op you have so much Morphine in you that you dont worry about much at all 🙂 Good luck, hope it goes well

  44. Thanks for the last comment Mark, can I also ask yo this, did also think in the days leading to surgery to cancel the whol thing? did you try to convince your self that you don’t need the surgery and should cancel it? That you Can manage without Surgery somehow?

  45. To be honest, i had no second thoughts. The surgeon told me i needed surgery (this was bout the 4th time i had seen him over 7 years and multiple MRI’s), so i just trusted him and went for it. Good luck with yours, Mark

  46. Hello mark and thanks for sharing your story.

    My question is about cortizone injections , if you had any and what was your experience with these injections

  47. Hello Mark,
    Hope you doing well, did you hea about or did what they call nerve blocking? My doctor mentioned it and wanted to see what you thoughts about it.


  48. Hi, they spoke to me at length on nerve issues, but told me that the risk was fairly low. I did end up with a minor issue where one foot is cold (never sweats) and the other warm; due to the nerves that control the blood flow down the legs being in that area. But, its not really much of an issue, Mark

  49. Hello Mark, thanks for your blog, really good. Iam in a stage now where I have to do the surgery to hopefully live life normally. My doc left the decision to me, this much harder than if he told me that I have to do it I guess. I just couldn’t overcome my fear from the surgery. If you have Any words to put my mined in some peace will be great. Thanks

    • Hi Sorry for the delay. All i can say is it changed my life and even if that is only temporary it is so much better than before, i can only hope you have the same success, so all the best, Mark

  50. Thanks fo your reply Mark, did you have leg/ feet numbness or pain before the surgery and did it improve after the surgery?
    Iam worried that ALIF will not treat leg issues.
    Also did you have cortisone injections at your back before th surgery? I had one few days ago and it made me feel worse actually.
    Thanks again Mark, my best wishes to you.

  51. I had a laminectomy with fusion performed in 2003 on L4-5, i had spondylolisthesis and canal stenosis. Now i am having my second back surgery March 15,2013 on L3-4 and L5-S1, same thing as before, stenosis and spondylolisthesis at these levels. This is right in front and right behind where my cage & screws are now. This time the surgeon(who is not the original surgeon from 2003,he retired) is going in from the front(ALIF) instead of the back. I am glad i found these comments, I was wondering about the recovery,etc and could not find a forum. I am 60 yrs old and have been in so much pain over the last 2 yrs especially that i am ready to get this over. thank you for your information

  52. i am going to have surgery in april on l4,s1, alif and i fear this,but this fall happen 2 years ago and the pain just keep getting dr. said he have done all he can but a really need this surgery. my surgery will last 5 and i said 5 hours because i got to have 2 stages done.1st stage ALIF with a allograft bone and 2nd stage PSIF.GOING IN MY FRONT THEN TURN ME OVER THEN GOING IN MY BACK.we all have something in common (FEAR)

  53. I am also finally going to do this surgery on 20th march, few days to go, took me 3 years of pain and suffering and limited movement to finally have the courage to do it. not courage really but rather despiration and fear from this problem becoming worse. mine will be one level but a microdisctomy will be done first from the back then taking bone graft from my hip then turn me face up and do the ALIF with heart/ vascular surgeon helping with providing the access to the spine from the front side.
    Well, don’t know what to say really, can’t even begin to describe how I feel now. I don’t think any human should go through this ordeal. But no choice really . Iam forced to do it not a hero

  54. I had ALIF surgery 10 days ago. My abdominal inscision is doing great but my back is still hurting a lot. I’m very weak and get extremely tired and have to lay down frequently. I find that I’m having to medicate every four hours instead of six. Has anyone else felt this way. I’m experiencing a deep radiating pain at the incision site. Walking feels good but I feel so tuckered out that I find I am mostly laying.

    • Hi, Christina, the main thing, try not to worry. I know it’s difficult, things ache and it’s easy to over analyse every ache and pain. I clearly remember lots of rest and thinking the following when trying to walk 1) will i ever get further than the front door when walking 2) then later will i every get past the post box at the end of the road 3) later still will i ever get beyond the cafe up the hill. It took me 3-6 months to realise i could walk just fine! Throughout the first years and still now, if i get a pain that is reminiscent of old i worry is it all coming back again, but so far it’s doing fine. So give it time and try not to analyse on a daily or even weekly basis, look back in 3, 6,12 and 24 months time and see the difference then. I very much hope that you see the improvement you wish for. All the best, Mark P.S i use to pop pills likel they were sweets, my doctor told me off and had to ween me off of Tramadol, oh how i loved that drug 🙂

  55. Hey guys, I’m thinking of having ALIF done in a few months time.
    Some background – 29 years old, had severe lower back pain over the last 7 years (i believe due to skiing accident).

    Just a few I was hoping to get advice on:

    Anything I can do in the lead up to the op to put me in the best situation possible (Ive read having zinc tablets, making sure I’m as light/healthy as possible).

    I know recovery is a case by case proposition but at the moment I cant run/jog without pain. Just wondering if people who were in similar situations had improved prospects of playing sport etc following ALIF?


  56. Well i could do no sport at all before and now i can happily swim cycle , run around and play football with the kids. I doubt i would play competitively , but have had a few tumbles and am still going . I have the normal aches, but don’t feel like i am about to snap in half (which i did before the op) good luck, Mark

  57. I am 67 years of age and have been suffering with a bad back now for over 2 years this is compounded with a trapped sciatic nerve which has the feeling of burning in my right leg and a numbness underneath the big toe of my right foot. The problem is caused by a disc missing or worn away in between L4/L5,[ so bone was rubbing on bone] this came to light after having an MRI scan and the surgeon deciphered the xrays giving me an explanation of why I cannot walk for more than 15 minutes in one go as I have to sit down and rest then get up and start again . Before anybody asks , yes I have been swimming for the last 15 months and had a cortisone injection which lasted 3 months and then the pain came back with a vengeance — so I do not know what else to do than have the operation , cant say I am looking forward to it but hopefully it will make me able to walk again without this horrendous burning pain ! Thanks to all who take the time to read this !!!

  58. My back has been hurting now for approx. 2 years and if I was to walk for more than 15 mins I would get a burning pain going down my right leg which really was horrific as I had to sit down to relieve the pressure on my back . So after going to the doctor a couple of times to try and investigate the problem I have ended up having an xray and an MRI scan + a cortisone injection to see if this would solve the problem – and it did for 3 months , yes it was bliss but then it wore off and the pain returned with a vengeance . I also went swimming twice a week for 15 months as physio was recommended as well but this did not ease the pain so after a lot of thought and deliberation I nervously went to see the surgeon armed with all the info that I had collected let him make the decision and he said that he could operate but the incisions would be front and back and that he would have to insert a metal cage with 2 screws to hold it all together as if not it could all slip back and I would be back in the same boat . So I have had the operation now and spent 9 days in hospital [ even included a bomb scare while I was in there but that is another story ], now I am at home and after 5 weeks I can walk about but I still have a pain now in my left leg but I guess I am still waiting for what they did in the operation to settle down. So we will have to see what happens next – watch this space !!

  59. hi,im 26 yr old male,suffering form degenerative disc disease and my surgeon had advised me for ALIF SURGERY@ L5-S1.can any one help me bat the pros and cons of this surgery

  60. Hi,

    I had ALIF surgery (L5S1) just on 1 year ago after having pain in my lower back for some 8-9 years (degenerative disc disease was clear on my MRI).
    I saw 4 different neuro/orthopedic surgeons as well as a neurologist family friend in the lead up to my decision with 2 saying they were confident surgery would help, 2 saying to live with issue/not have surgery and the other saying give it more time to improve.

    My symptoms included random sharp pains isolated to my lower back (more right side), consistent sharp pains with certain movements like jumping out of high car/ute or going down steep stairs, pain whilst my body was relaxed in bed at the end of the day and pain while trying to run or play sport. I would give it a consistent day to day 5/10 pain level with the sharp pains being around a 7. Luckily there was no nerve pain (I did have occasional pins and needles on left side but this didnt hurt much).

    I tried all conservative treatment options I had heard of over the years given surgery should be a last resort especially on your back. Treatments included physio,osteo,acupuncture,cupping,anti inflammatory pills, cortisone injections, nerve block injections, pain management therapy and more. I gained little improvement in managing the situation and therefore opted for the surgical option.

    Now for the surgery – I was in hospital for 3 nights and luckily did not need any narcotics beyond some Panadol either during my stay or the months afterwards. The pain was worst around the incision on my stomach. Walking after the operation was fine but you will obviously be very careful and take things slow. For the first two weeks back at home even though I was confined to bed I felt much better than I thought with minimal pain. Unfortunately one night after a few weeks I woke up in excruciating pain right in the area of my previous back pain and was really distressed and worried that the op had been a failure. Luckily this was an isolated incident and it more became a mental battle (trying to dismiss minor hurdles you come across and try stay positive) which is tough especially when confined to bed for a whole month.

    The next few months involved walking as much as possible, being super careful not to bend down/move too much and doing as much hydrotherapy as possible to regain movement and strength. Staying positive and motivated is key as this is a long, tiring battle.

    Now at the 1 year stage I don’t seem to have the sharp pains although I still have a constant soreness around my lower back which is maybe a 3/10 so quite manageable. I hope this will help people going through a similar journey. If you have any questions I am happy to try help.

    To good health!


  61. Has any one had chronic leg pain in back of legs and calf? Had ALIF almost 3 weeks ago. I did walk too much yesterday

    • Hi there, I would not panic yet. I had so many aches and pains for months after my operation. Also, even now every time my back aches (often due to the fact I do too much) I panic a bit.

        • I did the original post on this (its my blog), took about 18 months to feel super with mild aches. but a good 2-3 before i felt near normal

  62. Hey Mark! Not sure if you are still responding although 6 years after original blog impressive! I was looking for some info because I had a surgery similar to yours about 7 weeks ago. I had ALIF at L4/L5, cage and 4 screws. Yeah the morphine was the best! I’ve had good results so far, just slow. At first I had crazy numbness from my butt to my calves and I had not had had that before. Oh I should mention my initial reason for surgery was about 6 years back pain to inability to walk. Had gone to chiropractor year before and I think it may have worsened with them, felt great after sessions but progressed to more pain to just going down to ground stuck there! My area was bone on bone too. Anyways about 5 weeks after I felt great! Not bending twisting or lifting but was feeling good. Was thinking I was going back to work but Dr wanted me to finish all my PT first. Well just this last week have felt a deep dull ache in lower back area. Did you ever have that? I’m still waiting to start PT (insurance) and want to do some exercises or something to help myself but unsure of what to do. It’s nothing like the pain I felt before so I’m thankful, I just don’t want to mess up my progress. When I read someone’s post about playing paintball so soon after, it seriously hurt my back! Sometimes I overdo things like picking up toys and messes but I try not to. I want this to work and do what it’s supposed to. Any tips for after care months down to will be great! It gives me great hope to see you back to “normal”, I will actually be able to play with my kids later without being in immense pain.

    • Hi Nin, I think I may move this post onto its own blog as it seems to keep on going; I guess there is not much out there.

      Glad you are on the mend and to be honest mine was a fair while back now; sometimes I even forget I even had it. But, I do still get stiff now and do yoga type stretches and strengthen exercises, every morning and night. I also remember many aches and pains early on and I would constantly worry I was having a relapse (I still do sometimes) . Regarding after care I did have a Physio who gave me some exercises to do and showed me very clearly how to do them Over the years I’ve had some top up sessions to make sure I do things correctly, as doing them wrong can put stresses on your back. The key thing I have learnt is to ensure the right core muscles (and others) and are engaging before I exercise and ensuring that I keep my form i.e not over-stressing my back.

      For at least the first 18 months I would not attempt to carry much at all ( I would not even carry my laptop in a bag), now I will happily lift 10kg without worrying and will even list a suitcase into the car of approx 23kg (when I have all of the right muscles engaged). I think the thing I have learnt is to build up slowly, do the excercises you get taught, do them well, do them everyday.

      Then as my surgeon said ‘life is for living’ so don’t be afraid to do things

      • Did you move to a new blog? It is Dec 2017 and I am scheduled for ALIF in January 2018 and PIF 2 days later. I will turn 59 one week after surgery. Right now I can’t stand for more than 10 min or walk more than 15 or shop with a shopping cart more than 30 min without legs going numb. At its worst I thought I was going to fall down, which was scary! I have dealt with back pain for 25 years and sciatica numbing last 2 years. I stretch everyday and do physical therapy 2x week. After seeing X-rays of compressed discs I decided it was time for surgery. I don’t think any amount of PT, epidurals etc will fix this problem. The problem has really slowed me down, which was gradual so I did not realize it but when I have a good day I realize how much I’m limited most days. It’s depressing; I’m too young and want to enjoy retirement in a few years. I also feel like recovery will only be harder as I get older so sooner is better than later. Had a 2nd opinion last week and surgeon agreed but said he would do everything from the back —PLIF. It sounds like the front is easier recovery but any opinions would be welcome! Thanks so much for this positive space on back surgery!

        • Hi, I was told that ALIF was a quicker recovery as core muscles at the front are often stronger and easier to build up. It’s worth saying I was not given a choice, my surgeon just said he had universal success using ALIF; I did not question it, maybe I am too trusting 🙂

          All the best with your operation, Mark

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