Spine Fusion at L5 - S1

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krogers32570

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I have been suffering back pain for over 10 years, and have been recomended by my Ortho to have PLIF(Posterior fusion) at L5- S1, due to my fears of having the pedicle screws & roRAB, have asked for other options, he seems to think that a ALIF(Anterior Fusion) would work well too, but carries more risk, as it is preformed through the belly instead of the back. The Anterior has a shorter recovery time too that is much more attractive as well, any feed back on one verses the other???

Have been diagnosed with Spondylolisthesis at L5 - S1 with about a 55% - 60% slippage, bone spurs in the facet joints, the disc has been flattened, and some nerve roots on the right side are being pinched.
 
Hello and welcome to the board ~

I am a little confused by your post. Any fusion with instrumentation will most likely have some pedicle screws. It may or may not have roRAB. The PLIF or ALIF is just the way the procedure is performed, as you stated, from the back or front. Sometimes a surgeon will do both, operating from the front, closing and flipping over the patient, and then doing the PLIF.

I am surprised with your degree of slippage that a surgeon would be willing to operate on you without using roRAB and screws. ALIF is not as stable as the PLIF and is usually not used alone for cases of spondy.
 
Hi,
I have had both and the front did seem to be an easier recovery but I can't say one is better than the other since I have had 4 attempts at a fusion for L5-S1 and all have failed to fuse solid. I hate to be discouraging but it is a valid point to consider. Most do fuse and I am the exception to the rule, my body just won't grow the bone there.

I have had this pain for 10 yrs this year, lucky us huh. I wish you luck, it's a long road but it will probably be one worth traveling. I personally woudl opt for the hardware since that will help to steady everything while it's fusing, I don't think there is enough evidence in this country to overirde the good old dependable way, but that's just me, I'm hard to persuade.

Sorry I didn't probably tell you what you wanted to hear. Your case is almost identical to mine. I want to warn you that the nerve damage pain will take some time to heal, up to 12-18 months perhaps. I have permanent damage because of the length of time the slippage compressed the nerves.

Please keep us all updated on how you are?

God BLess

Carol
 
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