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Experiences with lumbar disc replacement?

athleteathlete Posts: 60
edited 06/11/2012 - 8:34 AM in Back Surgery and Neck Surgery
Hello. I'm new to the forum. I've had a sucessful right l4/5 microdiscectomy in 2006 and 2x microdiscetomies 7/09 left l5/s1. Fusion is a last resort for me so I'm curious about any experiences (personal or knowledge of others)with lumbar disc replacements. For example:

are you happy with the surgery? (positives and negatives)
when/how long ago did you have the surgery? what type of artificial disc, how many /what levels?
mobility/flexion/twisting with TDR?
able to resume preoperative or better function?
recommendations surgeon/facility?

I am hoping to hear about good experiences since an active athletic lifestyle is important to me. One of the problems with the internet discussions and forums is that the population tends to be skewed to less favorable outcomes since many who have done well are less likely to be involved in forums/discussions. But, it seems clear that there are certainly a lot of supportive and helpful people on this site.



  • Before you get your heart set on a particular procedure, have you checked with your insurance company to see if they will cover ADR? It seems recently that more and more people are being denied this procedure.

    How many levels do you need replaced?
  • Hi athlete,
    You don't list your age, but I think you should be very careful about the ADR, and which device you get.

    Some manufacturers are warning patients that these may need to be replaced after 10 years. Many surgeons are very concerned about the difficulties and dangers involved with replacement.

    Most of these are placed with an anterior approach, which means that the great vessels must be moved aside, which is dangerous enough the first time. And, each subsequent surgery is more complicated by more scar tissue and more adhesions, and more risk of tearing the aorta or other vessels.

    A patient in their 30s, may require 4 or 5 surgeries over their lifetime, each one more dangerous than the last.

    I know none of the options are great, and I am not trying to discourage you, but I think you should discuss the risks of future surgeries with your doctor.

    Sometimes the devil you know(fusion), is better that the devil you don't know(ADR).

  • 1 level-L5-s1 (less likely, 4/5 also).
    I hope to avoid TDR or fusion but if I re-herniate or fail again at L5-s1, I will likely be facing a TDR or fusion decision. Fusion is not good option for me-too young and active. I am preparing myself for possibilities down the road. As far as cost, I'm expecting that insurance may not cover the ridiculously expensive TDR procedure if I don't get into a trial but I am an excellent candidate for the procedure. Do you know costs? It still may worth the debt for TDR (it would hurt but cost is not a nonstarter for me) if it's half as good as described. Any impressions of others experiences with TDR?
  • Thanks Dave,
    Great points. I've heard some of the same concerns. This info and advice is extremely helpful. Like others, I'm just trying educate myself as much as possible about treatment options. If bad outcomes are frequent with TDR, it makes the decision easier. I think an extremely experienced TDR surgeon would likely be a must. If people are happy they went with fusion over TDR, I would like to hear about that also. Fusion is sometimes necessary but it would be easier for me to accept at age 60 than 40. I'm 40 by the way, but I (not my back) look like I'm 30.

  • Six weeks ago I had an ALIF (fusion) at L5/S1. The surgery went great and my recovery has been easy. The fusion at that level doesn't affect mobility or flexability near as much as a fusion at an upper level. If I had a choice I'd take the route that involved as few a surgeries as possible, but that's my personal opinion. One 3-6 month recovery is quite enough for me.

  • Hi: I was doing great for a month after my L5-S1 revision microdiskectomy. Five weeks ago, I ended up in a fetal position for three weeks- couldn't stand up or sit at all. Dr. put me on heavy pain meds (only made me sick) and medrol. Now, I can walk, but my back hurts a lot, my left calf feels like it has a lightening storm going on (constant zapping) and my left heel is numb. Any suggestions? Thanks!
  • How much are you able to do now and at 3 months? Could you work a desk job within a month? Thanks
  • Hard to say what may be going on. For me, the return of severe sciatic/radicular pain that made it hard to function was an indication that I had re-herniated at l5-s1 (1st a 15 x 20 x 16 mm extrusion then a recurrent herniation of near same size 2-3 wks post-op). Radicular pain rather than back pain that was worse when I coughed, laughed or moved in anyway clued me in that this was more than just typical recovery of a damaged nerve or my other recurrent back pain or recovery pain. I had surgery again since I've got to be back at work soon, I had worsening weakness, and a quickly shrinking calf. Conservative therapy wasn't an option for me. Doc wanted to do a fusion- but I had to try another microdiscectomy first (you'll have to drag me kicking and screaming to a fusion which may well be in my near future). Your Doctor is your best source for a diagnosis or treatment. But, whatever the cause of your pain-conservative therapy is first to consider.

    FWIW, I had a very successful l4/5 microdiscectomy 3 years ago- on a bike and working in a week but still had several periodic setbacks every few months which would resolve in days to weeks.
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