OT Lumbar Fusion

[2LeftCleats]

Hey Paceliners

I know lots of us have had back issues, so I'm asking for your experience.

Specifically, I’m seeking real-world experience with lumbar fusion. In searching the archives, there’s plenty about disc surgery, but not so much about life after fusion.

I've had spinal stenosis and scoliosis for years and have to stop and squat every couple of blocks. It's progressed despite conservative management. I won't go into all the specialists I've seen, the therapies and procedures done, but the bottom line is that I'm not a candidate for less aggressive options and will need an L4-5/L5-S1 fusion

Surgeon says that after 3 mos. I can do pretty much what I want and that I’ll lose about 10-15 deg. of flexion. I assume I’ll need some changes in bike set up, if not a hybrid. What adjustments have you needed to make? I’d love to hear from folks who’ve had 2-3 level lumbar fusion. Thanks.

[buddybikes]

3 level fusion here.

L4/5 - Dec 2015
L3/4 - July 2019
L2/3 - Feb 2024

I used to have about 8cm drop, that reduced about to about even now. I use Spec Rover bars. Not fun, but deal with what was dealt. I currently ride about 2,600 miles a year. Plenty of ongoing PT.

Good luck, as you probably know - look for the best in the business. If you are in New England area pm me.

[Onno]

I had an anterior lumbar interbody fusion of L5/S1 three years ago, and it's been kind of a miracle. I had lots of very sharp pain in my lower back for years, and within a day of the surgery I knew that the surgery had fixed it. Yes, the recovery took a couple of months (though I was walking the next day), but I've been 95% pain free in my lower back since the surgery. I was back on a stationary bike within about a month, if memory serves, and back to swimming more or less the same time as well.

[.RJ]

I had an L5/S1 fusion done 6 years ago now.

I had a lot of back issues for years, sometimes mitigated through PT, anti-inflammatories, core work and stretching, and cortisone shots - and sometimes not. Insurance company wouldnt approve surgery until several years of MRI's showed a situation that was getting worse. FWIW, I had stress fractures on both sides of my L5 vertebrae (no idea where they came from) and disc herniations.

I had one doctor tell me "not being able to ride your bike for 5 hours isnt a medical condition". It finally got to a point where it was impacting my life outside of cycling. One of my last rides before the knife was a really nice sunny fall day and I could only manage 45 minutes. Given that most back surgeries are both expensive and dont have great outcomes I cant say I blame them.

Post surgery, I was useless for 2-3 weeks and then I could do lots of walking and short trainer rides. I definitely over did it and pushed it to far at times on the trainer and I think it impacted my recovery timeline. But I think 3 months out I was back riding outside and feeling pretty good but couldnt do big days, and after 9-10 months it was pretty much complete recovery. No pain, no change in bike positions, sleep normally again.

A friend in a similar situation did a less invasive procedure to relieve pressure on the sciatic nerve (laminectomy maybe?) and that was a good outcome too. So two surgeries sucks if you still need the fusion, so get a 2nd opinion.

[Fat Cat]

Do Not under any recommendations or circumstances take Gabapentin !

From personal experience I can tell you that there are worse side effects even than those that are widely publicized - and there are a multitude of even those.

I had 4/5 fused in May 2023. I was walking the next day. I was off all pain killers in five days and only used Tylenol during those five. I hate drugs. Riding in two weeks. The doc just said listen to your body and don't be stupid.

These days I don't go far and I don't go fast but that's old age not the back.

[buddybikes]

Originally Posted by Fat Cat

Do Not under any recommendations or circumstances take Gabapentin !

From personal experience I can tell you that there are worse side effects even than those that are widely publicized - and there are a multitude of even those.

I had 4/5 fused in May 2023. I was walking the next day. I was off all pain killers in five days and only used Tylenol during those five. I hate drugs. Riding in two weeks. The doc just said listen to your body and don't be stupid.

These days I don't go far and I don't go fast but that's old age not the back.

Been on Lyrica (basically purified gabs) for 14 years, primarily for neuropathy. Once adjusted, no problem. To each his own.

[.RJ]

Originally Posted by Fat Cat

Do Not under any recommendations or circumstances take Gabapentin !

Why?

My wife takes it every night for restless legs.

[dave thompson]

My wife had an L5/S1 fusion, with minimally invasive surgery, about 10 years or so ago. She is an avid rider and was chomping at the bit to get back on her bike but waited the requisite time before doing so. Pre-surgery her bars were only slightly lower than her saddle, which post-surgery changed to level. Her riding time, intensity and endurance didn't change. Later that year she completed her 4th(!) Seattle-To-Portland ride, 206 miles in two days.

[2LeftCleats]

Thanks, all, for the encouraging info.

[buddybikes]

L5/S1 is bit tougher of surgery, usually through the back but occasionally through front. As a result back muscles are cut, which takes rehab bit longer.

First 6 weeks, walk, walk, walk, walk...did I say walk. Nothing else

6 to 12 weeks PT start, I recommend finding water therapy as adjunct, basically treading water, using floats in warm water. Stretching begins to breakup scare tissue

12+ weeks - off you go into wild world wonder

[.RJ]

Originally Posted by buddybikes

L5/S1 is bit tougher of surgery, usually through the back but occasionally through front. As a result back muscles are cut, which takes rehab bit longer.

Mine was through the front, and then the next day when everything looked ok, another procedure to put 2 screws in through back.

Thinking about it now it sounds a little barbaric.

[Spoker]

[QUOTE=Fat Cat;3434461]Do Not under any recommendations or circumstances take Gabapentin !

From personal experience I can tell you that there are worse side effects even than those that are widely publicized - and there are a multitude of even those.
/QUOTE]

Can you elaborate?
Taking it occaisionally and it does slow me down big time, but does decrease leg, back pain.

[Ozz]

Full recovery at 3 months seems pretty optimistic....probably depends on age and dedication to rehab.

I was back on bike after about 6 months and about a year for full recovery.....

[Fat Cat]

[QUOTE=Spoker;3434551]

Originally Posted by Fat Cat

Do Not under any recommendations or circumstances take Gabapentin !

From personal experience I can tell you that there are worse side effects even than those that are widely publicized - and there are a multitude of even those.
/QUOTE]

Can you elaborate?
Taking it occaisionally and it does slow me down big time, but does decrease leg, back pain.

Just do a search. There are a bazillion horror stories.

[tellyho]

My son just had lumbar/thoracic fusion this past June (he's 18). Off to college in August with no problems. He has other issues (spina bifida), but recovery from the spinal fusion was faster and easier than either of the hip surgeries he's had. Granted, 18 vs. old (I assume).