Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

L5 S1 Disc replacement or fusion

I herniated my L5 S1 disc about a 2 years ago and had a microdiscectomy done to repair the herniation. I was pain free for a few weeks and now I am having constant back pain. I had an MRI last week and just went over the results with my doctor. Results show degenerative disc disease in me L5 S1 disc only. All other discs look perfect. My options are a full disc replacement or a spinal fusion.

My doctor is sending me to Boston to see someone that does the full disc replacement surgery. He says I am the perfect candidate. I am early 30's and I take very good care of myself. I eat a very clean diet and I exercise daily. I am in great shape currently as I am very active. I am not sure what would be the best option for me, disc replacement or fusion. or just deal with the pain.

I am interested in hearing from people who have either had the L5 S1 disc replaced or had these vertebrae fused. I am not trying to be rude at all here but if you have had a fusion or disc replacement surgery for anything other than L5 S1 I am not interested in hearing you opinion. Sorry if that sounds rude but disc replacement and fusions are completely different in different areas of the back/neck.

I have read on here that people are being told a disc replacement in L5 S1 allows for too much movement in the spine and that can cause complications.

If you have had L5 S1 disc replacement or fusion please let me know how it went and how recovery was. Even if you have spoken to doctors about these two options but have not had the surgery I would love to hear what they told you.

Thanks in advance.


  • LizLiz Posts: 7,832
    Please take the time to read this post and refer to it when you have questions

    I am sure that you will find your time on Spine-Health very rewarding. This site is a powerful and integrated system that is dynamic and growing.
    Here are just some of the highlights that are available as tabs on the main Spine-Health menu bar

    Spine-Health Main Menu Tabs

    Conditions Detailed medical libraries of articles and videos that address almost every spinal condition.
    Treatment List of treatments to the conditions identified by Spine-Health.
    Wellness Section contains articles, tips and videos to help patients after surgery and also to help people avoid surgery.
    Spine-Health Forums These are the forums you will be using
    Find A Doctor This provides with a method to search for doctors in various locations.
    Doctor Advice Health Center The Resource tab, has many important features. You can browse various doctor advice on given spinal situations, you can browse clinical trials and view a comprehensive glossary..
    Health Videos Index to all Spine-Health Videos

    As a bonus, Spine-Health provides these patient forums. Here you can meet thousands of people who understand and can relate to your situation. You will soon become part of the Spiney family[/u] who provide comfort and the advantages of a support system. You are now part of this family that is approximately 27,00 international members and growing daily.


    - It is very important to understand the Forum Rules to make sure all of your posts[u] do not violate any of the rules.[/u]

    - All new members must read our FAQ in order to understand the layout of the forums, how to navigate through the forums, helpful terms, how to make effective threads and posts, plus a link index to many of the important medical forums and key medical articles on Spine-Health Forum FAQ

    I am positive any member, new or old will find this Chroinc Pain - Step by Step thread very valuable.

    Here are some links that all new members need to review to create effective threads and more

    Read before you post
    Tips for Newcomers
    Understanding the rules

    All of this will help make your threads better and improve the times and quality of responses you will receive.

    You can also find Spine-Health on these Social Networks

    Facebook www.facebook.com/spinehealth
    Pinterest http://pinterest.com/spinehealth/boards/
    Twitter https://twitter.com/SpineHealth

    If you have any questions or need assistance, you can use the private message facility to[u] contact any one of the Spine-Health Moderators







    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Todd In PainTTodd In Pain Posts: 23
    edited 01/31/2014 - 4:32 AM
    Frankly, Artificial Disc/Disc Replacement is a failied theory. I had it done at L5-S1 three years ago, non-stop complications ever since. I'm in my 40's, great shape and active. Now I'm, facing even a bigger surgery, explanting the artificial disc and having it fused. Artificial discs are very new & more and more complications are coming out of the woodwork on this. .EDIT Fusion is the gold standard. Now all spine surgeons are recommending removal of the artificial disc which has SERIOUS complications & risks, you should read about it, my surgeon never informed of any of these risks. PLUS, once you have an artificial disc implanted, you could never see a clear image on an MRI/CT, it has too much "Artifiacts" & no Radilogist can see if there is nerve compression from the artificail disc. Wish I had this level fused. Good luck.

    Post Edited by Liz The Spine-Health Moderator Team
  • I'm fused L4-S1. My surgeon is one of the top spine surgeons in PA and he refuses to do artificial disc replacements. In his experience it's difficult to get insurance to pay for them and more research needs to be done. From what I've read it's still inconclusive how long the replacement actually lasts. I wasn't interested in taking the risk and needing another spine surgery in the future at the same level because of the possibility of the replacement giving out. I'm extremely happy with my decision to have a fusion and am almost pain free for the first time in ages.
    10/28/13 - ALIF, PSF, decompression at L4/L5 and L5/S1
  • Thanks for the feedback guys. My doctor who is recommending the full disc replacement doesnt actually do the surgery. I dont think he is overly familiar with the complications and thats why nhe is sending me to see someone who does do the disc replacement surgery. After everything I have read I do not think I will be getting a disc replacement.

    Todd, what complications have you been having since the disc replacement?

    Steve, how long was recover from the fusion? How long til you were pain free?
  • I'm 3 months out and I feel awesome. All of my pre-op back pain is gone and I have minimal nerve pain, a 1 or 2 out of 10 at worst, normally brought on by standing too long. Going into the surgery, I was told to expect a 70% chance of reducing 70% of my pain. Full recovery - solid fusion and nerves healed - can take a year or longer.

    My recovery went smoothly, but I'm also young. I was in the hospital for 4 days and the first week was rough. I used a walker while in the hospital, a cane for a day or two once I was home. My surgeon told me the day I was discharged he wanted me walking 3 times a day and to increase the length as I could and I stuck to that.

    By week 3 I was off pain meds and walking 2.5+ miles a day. My surgery was Oct 28, I had been on nerve pain meds for a long time and was off of them just after Thanksgiving. My surgeon recommended at least 6-8 weeks off of work, but I work from home, so I started working much quicker than that.
    10/28/13 - ALIF, PSF, decompression at L4/L5 and L5/S1
  • sandisandi Posts: 6,343
    edited 01/31/2014 - 11:43 AM
    I spent a lot of time when facing surgery, looking into and learning about adr ( artificial disc replacement), the models available, the designs, the doctors doing the implants, success rates and more importantly failure rates.......I didn't buy into the articles written by doctors who were being paid by the companies, but rather waited for studies which didn't involve those doctors, and what I have read and learned from talking to tons of people who did and didn't go through with the surgery, was not good. Those who have had them implanted in the lumbar region have not had good outcomes. Exclusions per the manufacturer's , in the beginning were followed, no facet joint problems at all, previous surgeries, etc and sooner than you could imagine, all of a sudden, those exclusions were no longer being followed, patients with facet joint problems were getting them implanted, multiple levels were being done, and the majority of those who underwent adr have had major problems since then. Facet joints that were healthy were no longer and people wound up facing a life threatening revision surgery due to the large abdominal blood vessels in the area where the adr is implanted, that was, if they could find a surgeon who knew how to do a revision.
    Subsidence ( movement of the disc) in the vertebral plates was another issue, or placing the wrong size disc in the disc space were others. Some referred to it as distraction pain, and told that it would disappear but for many, the pain in the post op period was far worse than any they'd had previously.
    The design of the current adrs out there is marketed as preserving spine motion, but the reality is that your lumbar area does not have 360 degree rotation, because our bodies are not made to move that way...and when adr is implanted at the L5-S1 level in particular, it seems to cause even more problems than other levels, although the other levels have just as many complications.
    Most of those that I knew who had it done, wound up facing revision to fusion, a few found surgeons willing to remove the adr, but faced severe complications and worries for the outcome........so , please, before you buy into the advertisements regarding adr, do your homework, and just because some doctors have done thousands of them does not mean that the outcomes were successful.......
  • Westcyde, complications from Lumbar Artificial Discs that I have suffered from are weakness, numbmess, pins & needles in both feet, burning feed, foot drop, these are all nerve injuries, pain in feet, severe abdominal complications, these are all nerve compression issue from artificial discs. Looking at revision surgery and fusion currently. Stay ways away from the hype of this defective product, or design & good luck.
  • Are you doing any PT? I had fusion L4-S1 on November 26th.I do am doing very well. I do still have some lower back pain and stiffness.I am only on oxicodine one time a day.I can not take any pressure on my back. I have no leg pain anymore, so that is great! I went back to work part time after being out for 8 weeks.I will be going back full time on Feb 10. Any suggestions on what the next few months will bring. You seem to be about a month ahead of me. Thanks
  • SteveTSSteveT Posts: 178
    edited 01/31/2014 - 1:55 PM
    Jilro14534 said:
    Are you doing any PT? I had fusion L4-S1 on November 26th.I do am doing very well. I do still have some lower back pain and stiffness.I am only on oxicodine one time a day.I can not take any pressure on my back. I have no leg pain anymore, so that is great! I went back to work part time after being out for 8 weeks.I will be going back full time on Feb 10. Any suggestions on what the next few months will bring. You seem to be about a month ahead of me. Thanks
    My surgeon doesn't believe in PT. He told me on Tuesday he doesn't want any therapist twisting me up like a pretzel lol. He just wants me to keep walking everyday. He is a very conservative surgeon - I'm 3 months out and still can't do any repetitive bending or twisting and he wants me in a back brace for another 3 months whenever I'm outside of the house.

    The stiffness gets better. I started using a heating pad at night to help with that. Before surgery I wouldn't go anywhere near a heating pad because it made my nerve pain worse.
    10/28/13 - ALIF, PSF, decompression at L4/L5 and L5/S1
  • Hey Todd
    Sorry to hear about your continued pain and the fact you are facing a revision surgery. What kind of ADR did you have inserted. There are some models that are better than others. I have done a lot of research on ADR as well and I am finding many success stories. I am on the fence what type of surgery I am going to have and still finding out as much as I can. Good luck to getting back to good health.
  • I hade 5 years of back trouble. With a torn disk. I also had degernative disk disease buldging disk in my mid back and t2 and t3. I opted for the disk replacement for my L5 s1 disk. This was done in 2005 in richmond va and was a clinicle trial. Since then the fda has approved disk replacement using the atrifical disk called a maverick. It is wounderfull and wish I had done this years before. I was at the point. Where I couldn't walk before I done my sergery. There is no pins are no bolts n my back. I feel wounderful and it seams like I never had surgery. I was in hospital for a week and went home doing slow but normal activity and returned to work w no restrictions with in 6 t 8 weeks. My dr also opted for physical therapy for about a month after surgery. Its the best thing I every did. I have since been n a major car wreck fell on my butt and back 3x after surgery all with in a month and it never bothered my back r the artificial disk. Its still in place and has never moved. Research the disk they are gonna use and if its the maverick rush to the hospital and have the surgery you will not regreat it I promise
  • Since my replacement it has been wounderful. Its going on 9 years w no pain and no. Restrictions. Its wounderful. When I done mine I was under a trial but since then it has been fda approved. Maverick is the name of the disk and its used for one level replacement mine L5 s1. There is no stiffness like it is w rods n your back u have all your normal flexabitity like before you had surgery go for it
  • Hi Mark,
    Thanks for your kind words. I've had ProDisc artificial Disc at L5-S1, Fusion at L4-L5, another ProDisc at L3-L4. Problematic level seems to be L5-S1. In the last 3 years, I've tried it all, anything to do with conservative treatment or pain management. I'm finding that in order to get rid of problem, the level at L5-S1 needs to be fused & artificial disc explanted. Bottom line, I'm now learning that any artificial disc at L5-S1 is a failure (according to all spine surgeons that I've conulsted with, with the exception of the spine surgeon who did my impant, he is in denial, but has not done another single implant at L5-S1 after my surgery). Also, I know of no one that has a successful artificial disc surgery at L5-S1, it seems, they all fail at this level in due time (regardless of manufaturer or claimed superior design). I was told not to have a artificial discs by other surgeons because fusion has much more predictable outcomes, but unfortunately, I fell for my surgeon (and literatures out there) with their big hypes over motion preservation of artificial discs, bottom line, don't be fooled with artificial discs hype, it does not work in the lumbar, specially at bottom levels such as L5-S1. Good luck with your health, decision and recovery.
  • My neurosurgeon dislikes and discourages lumbar disc replacement. A year ago, I asked him what the best "money is no object" option was for me and my herniated L4-L5 and L5-S1, and he said fusion. I asked about ADR, and he said no as every lumbar ADR he's done ended up being revised to fusion as the plastic bearing surfaces either cracked or "squirted out" under pressure.

    He likes cervical ADR, and did my C5-C6 ProDisc two years ago. The difference is that a head weighs about ten pounds, but the lumbar implants have to bear about 75% of your body weight as a static load and a lot more dynamic loading from walking, running, carrying things, etc.
    August 2013 C7-T1 MED
    July 2013 L4-L5-S1 TLIF
    December 2011 C5-C6 ADR
    April 2009 L5-S1 MED
  • Thank you for your feedback, your are absolutely correct, I've heard that before. How is your two level lumbar fusion now? Your spine surgeon seems very knowledgable and honest. What is your spine surgeon's name and City? Thank you for your feedback.
Sign In or Register to comment.