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L4-L5 TLIF postop course

I previously posted in the Back Surgery and Neck Surgery Forum.  My wife had surgery yesterday so I am now posting in the Recovering from Surgery Forum.  This was her second surgery.  The first one, a L4-L5 microelectronic was a year ago in October 2017, left her with chronic pain.

Today is day one after surgery.

The one level TLIF with supporting titanium rods took about two and a half hours.  The neurosurgeon said there was scarring around the nerve from the prior surgery that he removed.  He said removing the scar tissue may cause more nerve pain at the same area as before for awhile.  After recovering from the anesthesia, the pain was pretty manageable with IV meds but she had severe nausea and vomited multiple times.  She was unable to eat.  

She had severe pain in her left leg and some pain in her right leg prior to surgery.  She can't tell if the pain has changed get since her legs are wrapped in tight cuffs to a machine to prevent blood clots.  The physical therapist already came by but therapy was not possible because my wife could not move her body due to pain.  



  • Today is post-op day #2 after L4-L5 TLIF.   Still in the hospital.  Nausea continues to be a problem; taking fluid okay but can't eat.  Urine catheter removed today and pain medications are in pill form.

    I saw the physical therapist twice today and learned how to use a back brace.  I was able to walk a few steps with a walker.  The severe pain I had in my left leg prior to surgery is much less.  I have pain in the right leg which I had before surgery, but not severe.  Pain in my back in about 8/10.

    I was told I have a slight fever, not sure of the exact temperature.

    The case manager came by and talked about going to a rehabilitation or skill nursing facility when I am discharged.

  • Today is post-op day #3.  Back pain is a little less, maybe 6-7/10 with oxycontin.  Nausea is less and I was able to eat some cereal and a small amount of chicken.  The physical therapist made me walk with a walker.  I had pain in both legs when I walked.  The neurosurgeon said it's too early to say whether the pain will stay or not.  Elevated temperature seemed to have resolved.

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  • Today is postop day #4 after my L4-L5 TLIF.  I was discharged from the hospital to a rehab/skilled nursing facility.  The hospital wanted to transport me in a wheelchair van or car but I insisted on a Guerney van because I was worried about sitting and getting stuck in traffic.  I'm eating better and the nausea is less.  I have mild left leg pain and no pain in the right leg when I am lying down.  Left leg pain 6/10 when I walk using a walker, which is a little better than pre-surgery.  Right leg pain when walking is now 2 to 3/10.  

    back pain is at 7/10.

  • Today is post-op day 5 after my L4-L5 TLIF.  I am taking one tablet of Norco 3 times a day and Tylenol for pain.  I also take gabapentin.  Pain is 5 to 8/10 in my back.  Left leg pain is 2 to 3/10  with numbess.  The left leg pain was 5 to 8/10 before surgery with numbness.  My right leg pain is now about 2/10 but only when I walk; no pain when I lie down.  

    I am using a walker and can use the toilet without assistance.  My appetite is about 70% of normal.  I have a back brace that really helps a lot.  I'm thinking about leaving rehab and going home soon.

  • hvillshhvills Suzhou, ChinaPosts: 989


    It sounds like you are progressing really really well... keep up the good work.

    Getting home can help... but don't rush things... your recovery will be a long road.  Think of it as a marathon and not sprint.  When you do go home be sure your physical therapist and your doctor have fully versed you and your husband on the must do's and don'ts... along with a strict exercise/strength building routine.  A good recovery process/routine is key to the final success of your surgery.  Press your professional support staff while they are available to you... there is no such thing as dumb questions in this recovery process .

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  • I've learned a lot from others in this forum and I appreciate all the advise from those who know from their personal experiences.  Today is postop day #7 of my L4-L5 TLIF.  I have pain in my back at 6-7/10 when I walk with a walker.  I also have pain in my left leg that is similar to what I had before surgery but less severe.  Minimal to no pain in tight leg.  The pain might seem worse because I'm cutting down on Norco.  I am now only taking two Norco tablets per day (only at night so I can sleep). I'm still taking gabapentin.

    The doctor told me I will likely be discharged to home in 4 days.  My husband is now buying a raised toilet seat, a stool (so I can get into the bed), and as lock box for the front door so I don't have to answer the door to let visitors in.  

  • Hi I read your story pre and post op. Glad you’re doing well, I know how hard it must’ve been with the change in activity level. My husband is 59 and I am 58. We also lived an active life and work full time. Presently I’m recovering from T4 to pelvic fusion on 5/21/18. Trying to stay positive and patient, many days are very frustrating as I cannot do what I use to. I hope to return to work in January, and will work my way back to how active we were, although some movements now will have to be modified. Stay positive, and good luck.

  • It has been 10 days since my L4-L5 TLIF.  I am still in the rehab facility and was told I will need to stay another 4 to 5 days.  The physical therapist doesn't think I'm ready to go home yet, in part because I live in a 2 story house and need to climb stairs.  My back and leg pain haven't changed.

    Because I wasn't sure whether I can go back to work even after the surgery, I have applied for social security disability just in case.  I hope I can work but sitting at a desk job all day might be a problem. 

    For those who may need a rehabilitation or skill nursing facility after surgery, I would recommend getting a list of the facilities that contracts with your health plan and visit them before surgrru.  It's better if you pick the facility rather than the case manager.  I don't really like the facility where I'm at but it's partly my own fault for not doing the necessary research.I

    SammyTB, I wish you well.  We both seem to be in similar circumstances.  Does a T4 to pelvic fusion mean you had fusion at many levels?

  • Today is day 17 after my L4-L5 TLIF.  I left the rehab facility 2 days ago and came home.  I spend most of my time lying down since sitting and walking causes pain.  I can sit comfortably for about 15 minutes and I can walk about 10 minutes before the pain gets too uncomfortable.  The pain is about 3-4/10 in my back and left leg when I lie down.  I seem to have more numbness in the left leg than before surgery.  My meds are gabapentin 200 mg/d, Tylenol 2 times/d and 5 mg of oxycodone at night.  I see the neurosurgeon for follow up next week.  

  • I am now in postop week 4 after my L4-L5 TLIF.  I still have pain in my back and my left leg.  I also have numbness in my left leg.  It seems like I have more pain now than a week ago.  I'm thinking of might be from my doing a little more around the house being mindful of no BLT.  I saw the neurosurgeon a week ago and he said the X-rays show everything is in place.

    I can walk around the house without a walker.  I can walk 50 to 100 feet with a walker outside the house.  I take one 5 mg oxycodone at night.  I also take acetaminophen and gabapentin.  I cannot work and applied for Social security.  My focus is not to do anything that will hinder my recovery.  My pain lying down is 2-3/10.  My leg pain standing and walking is 5-6/10.

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