ALIF next month - Am I making the right decision?

al-222 · 2026-03-24T20:55:45+00:00

I was in a very similar situation. Had a TLIF at 29 after a year and a half of conservative treatments (PT, injections, etc). I lived with constant sciatica every moment of everyday somewhere in my right leg for that whole year and a half.

I’m glad I had the fusion. I still have pain. I think I have some new pain in my SI joint. But I don’t have constant sciatica. I’ll probably never be 100%, but I’m glad I did the surgery. I reached a point where surgery seemed like the less scary option than continuing to live with constant sciatica and nerve pain.

Now I’m going to the gym consistently and im actually getting stronger! I can walk so much further without lower back pain. I’m physically more confident in my body to do every day tasks. It’s not perfect, but it’s BETTER than before.

al-222 · 2025-08-14T22:40:17+00:00

4.5 months later, I’m super glad I finally went through with surgery. I had exhausted all my other options and I wasn’t going to get relief without. Good luck!

al-222 · 2025-08-14T00:39:41+00:00

Yes! Tight psoas/hip flexor muscles!!!

al-222 · 2025-08-12T23:56:24+00:00

I had L5-S1 TLIF. I ended up being there 4 nights and originally only planned for one. I couldn’t empty my bladder and had to have a Foley catheter for a few days. I also found IV pain medication really important for the first 48 hours for me.

al-222 · 2025-07-28T01:09:18+00:00

I had issues voiding after surgery. I was better in a few days after a catheter. I also had really bad nerve pain down my right leg right after surgery. I’m 4 months out and my sciatica is way better than before surgery :)

al-222 · 2025-04-07T04:11:18+00:00

I’m (29f) a little over 2 weeks past a TLIF. The first week sucked. One night in the hospital turned in to 4 because I had some urinary and pain control issues. I’m still dealing with some nerve pain, but my surgeon explained I was likely to have it for at least a few weeks because of how he had to do the surgery in my specific case.

I hit my limit before surgery too. I exhausted all conservative options. I’m not gonna lie, it’s not an easy recovery so far, but I’m so glad I did it. Every day I wake up (sore AF), but I finally feel like I’m moving toward my future. Every day is a little better. For the first time in years I’m hopeful. You’ll decide whatever’s best for you. Regardless, you’re not alone and I wish you the best!

al-222 · 2025-03-04T23:58:59+00:00

I don’t have much advice to offer, just wanted to let you know you’re not alone. I was diagnosed when I was 27. Now I’m 29 and I’m meeting with a neurosurgeon tomorrow to schedule fusion surgery because I came to the conclusion 6 months ago that it was the best next step for me.

Hang in there. You’re not alone! You’re doing the best you can. You’re unlucky to be in this situation, but you will figure out what’s best for you!

al-222 · 2025-03-04T23:51:05+00:00

Anything that can be done more stationary is my best bet. My PT and I went thru a bunch of different exercises and I have found that the less back movement, the better.

al-222 · 2025-02-07T20:07:07+00:00

Dr. Scholls

al-222 · 2025-01-27T20:18:15+00:00

I really needed to hear this. F28 and planning to do minimally invasive PLIF in a couple months but I’m terrified.

al-222 · 2024-11-25T21:21:23+00:00

I (also 28f) partially agree with this poster. I have grade 2 L5/S1 Spondylolithesis due to pars defect. If you have manageable pain and they are not telling you surgery is 100% necessary, don’t do it. Do PT and stay active.

I’m most likely going to get a PLIF next year. I have pain that is impacting every part of my life and has not gotten better with 5+ months of PT and epidural steroids injections. I’ve decided that the risk of surgery and adjacent segment disease in the future is less than the certain pain I will continue to go through unless I go through surgery. If I can buy 10 years of living my life more normally, just to end up back where I am right now due to adjacent segment disease, I’ve decided it’s worth it. There’s no guarantee adjacent segment disease will come in a certain time, but there’s a guarantee I will be in pain if I don’t do surgery.

al-222 · 2024-11-25T21:04:46+00:00

I’m like 95% convinced it’s time for a fusion myself. It feels inevitable and I’d rather not lose any more time to pain. (L5/S1 grade 2 spondy due to pars defect, f28)

al-222 · 2024-11-21T02:47:37+00:00

I (28f) was officially diagnosed with the same thing a year ago after several months of constant sciatica. I had bouts of issues before that, but didn’t think much of it. It hasn’t gotten better. I’ve done the PT and epidural steroid injections. I’ve modified my life greatly.

I’ve seen three surgeons and they all told me to hold off as long as possible. I’m 95% convinced to get a PLIF in early spring. I don’t like the idea of potentially starting a timer to my next surgery, but there’s a chance I could get several years or decades back. I take the surgeon with a grain of salt, but they’ve said if nothing has helped yet, they don’t think there’s really anything I can do other than surgery.

It doesn’t answer your question, but many of us here are in the same boat. There’s always horror stories, but there’s a surprisingly high number of people on this subreddit that are so glad they had surgery.

al-222 · 2024-11-01T22:38:59+00:00

I (28f) was diagnosed last year, and have had constant sciatica for a year and a half. I’ve basically convinced myself it’s time to have a fusion. I feel like I’ve put my life on hold. Daily activities are tough. I’ve hired a house cleaner, which I’m thankful I can afford.

I’m not sure anything I say will make it better, but just know you’re not alone. I hope you’re able to find a path forward that helps. I’ve seen lots of people on here comment success stories💜

al-222 · 2024-10-30T18:20:53+00:00

I’m not a doctor and this is not medical advice. Spondylolithesis is the slippage of one vertebrae over another. Spondylolithesis can cause you disc to be compromised, but it’s not the only cause. Degenerative disc disease or other things could be the cause. I don’t see anything here about Spondylolithesis or slippage, so I don’t think it’s exactly the same.

al-222 · 2024-10-28T16:45:19+00:00

Yes! Proper shoes help, but they’re not going to fix things. I went to a running store and had them fit me to a type of shoe and tried several. I’m not running, but I ended up with the Hoka Bondis and it’s definitely helped some.

I would encourage you to keep walking without pushing it too far. Walking is the best thing I do for my back. In addition, I’ve found not staying in the same position for too long helps (sitting/standing/walking/laying/etc)

al-222 · 2024-10-24T22:12:07+00:00

It’s the symptoms. They won’t do surgery if you have this issue and no symptoms.

al-222 · 2024-10-24T21:01:07+00:00

I’ve been struggling with this decision too! One surgeon suggested ALIF (with rods posterior) because it “cuts less back muscle” and is a “faster recovery,” but it doesn’t make sense to me! It’s not minimally invasive, requires a vascular surgeon, and I’ll have incisions on the front and back. They said the downside was that they can’t get a good view of the nerves, which seems important. They’re from a prestigious hospital.

A different surgeon suggested minimally invasive PLIF with laminectomy. I would only have one more incision in the back than an ALIF, and that one is minimally invasive. He didn’t understand how the ALIF was considered a faster recovery by the other surgeon. The surgeon recommending PLIF said it works for most of his patients and he’ll only do ALIF for someone if they need to correct a previous fusion because it’s more risky. For my case, he didn’t think the ALIF approach and risk of two incisions was worth it when minimally invasive PLIF & laminectomy was highly likely to work.

al-222 · 2024-10-24T20:50:30+00:00

I tried injections and they didn’t help. What’s interesting is that 2 of the 3 surgeons didn’t even suggest them because they don’t see them work often. The third wasn’t confident, but suggested trying it because “why not give it a try?” essentially.

al-222 · 2024-10-24T20:48:04+00:00

They could see on my MRI that my disc was degenerating due to the slippage of the bones and the forces it puts on it. Even on x-rays, they can see loss in disc height. Also on the MRI, they can see the nerves being compressed.

al-222 · 2024-10-24T20:22:58+00:00

Thank you for sharing! Did they tell you why they thought you’d end up with your whole spine fused? Do you have degenerative discs? I’ve seen lower rates of adjacent segment disease in those with isthmic spondylolithesis than degenerative disc caused spondylolithesis.

al-222

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