6 Days Post L4 - S1 Decompression and Fusion

Hi Guys,

Just posting from rehab hospital bed 6 days after surgery.

Surgeon performed a posterolateral fusion with instrumentation only since he couldn’t make enough space to get a cage in without risking serious damage to nerves. He feels with a good fusion it should still be strong in the fulness of time and that the cage/anterior fusion is not necessary for a good result. I hope he is correct. Can anyone provide comment that this type of fusion can still be very robust.

Surgery went for 6 hours and was complex due to degree of compression.

All pain currently is post surgical and is quite intense, although in recent years I had not experienced any back pain, surgery was performed due to a bilateral foot drop and associated L4 L5 pattern weaknesses that were worsening. Foot drop had been going on since January 2020. No neurological symptom change since surgery, although no worsening has occurred which us encouraging, it seems recover of motor function may be a slow and perhaps incomplete process.

Anyway hoping to be on the treadmill soon, say the end of next week and maybe sneak onto a couple of machines for some super light sets of perhaps some chest presses and chest supported rows.

Over rehab I think I need to focus on getting leaner rather than eating to maintain size, as the latter will be hard to manage without lifting heavy and then just getting fat. And muscle memory means it comes back fast right.

Anyway thanks for any comments, tips, words of experience to keep the chin up, and if there is any interest, I’ll give a few updates over the coming months that may end up helpful to someone else.


Expect a possible timeline of 6-12 months of recovery, perhaps consistent with what I have seen with lumbar fusions. I have been a PT assistant for over 30 years, and that is the general timeline for the ALIF’s that I have seen. As the surgery heals, the symptoms should begin to centralize (i.e., retreat up the leg and concentrate to the back). Don’t try to rush anything at this point, and get plenty of walking in. Doesn’t have to be on a treadmill. Lifting, at this point, could be risky. You will probably be following up with your surgeon at the 5-6 week point, where he would offer his recommendations for activity. Keep your eye on the big picture. Perspective is key here.