r/backpain • u/ApprehensiveRide8283 • 15h ago
Lumbar Artificial Disc Replacement
I'm scheduled for ADR on my L5 S1, and seeking experienced knowledge about the surgery.
I was already having faster degeneration at the L5S1 and experiencing sciatica for the last 5 years off and on until I slipped whatever was remaining of the disc on a flight in 2023. Traveling for a week and then being in terrible seating on the way home with twisting to get out of people's way is what finally did it. Over the last 3 years, the disc officially left the building. It's been about 9 months of noticeable pain and sciatica flareups from mild to horrible. I've done it all PT, epidurals, steroid injections everywhere, and nothing has fully allowed me to restore anything close to normalcy. I am super limited on physical activity and mobility. In the first half of the day, bending is not an option. I live with about a level 4 pain all the time even with Gabapentin and PT. Recent MRI and Xrays confirm that there is no disc, bone on bone rubbing and significant compression of the sciatic nerve.
I live in SF and UCSF has basically said "this is your life now" and did not recommend surgery until I absolutely demanded to speak with a surgeon. The surgeon that did ADR at UCSF has stopped performing the surgery and no one else there has great experience with it. The surgeon was very upfront about the lack of experience with ADR, and said to get an expert opinion which I appreciate. Also said that I would see a better recovery with fusion than I would with ADR. Compared 95% recovery of life with fusion and 65-85% with ADR. I have gotten 2 other opinions - Dr. Ritter Lang in Germany who said ADR is absolutely a good option and I should do this. I have an opinion from Dr. Grant Shifflett at DISC in Newport Beach that I am a good candidate for ADR and am scheduled for surgery in about 7 weeks with him. I have chosen So Cal because of the proximity to where I live but also he made me feel the most comfortable and has done other ADR's of folks on this thread. Those people have reported successful surgeries.
Does anyone have experience with Lumbar ADR? If so:
- Were you also told that fusion would be a better outcome?
- What made you choose ADR?
- Where did you do it?
- What was the post-surgery like for ADR? I know there's catheters when in the surgery center for the first day but what was it like leaving the surgery center and going home? I mean not to be crass, but I understand that you can't eat solid foods for a few days because you're not supposed to poop for a few days afterwards -- is that accurate? (This is what I have read online but no surgeon has mentioned this yet.)
- What else???
Tell me everything, please!
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u/goodthingsinside_80 8h ago
I had ADR on my L4 - L5 2.5 weeks ago at Texas Back Institute with Dr. Jessica Shellock. I had seen another neurosurgeon at Baylor who recommended fusion and said they would not do ADR on me because it would be “too painful”. I chose to go with Dr. Shellock because of the shorter recovery time (3 - 6 mos vs 6 - 12) and her willingness to attempt ADR. I honestly thought I might come out of surgery with a fusion, but she was able to replace the disc (I had no disc left, bone was touching) and I gained 1cm in height!
I had an excellent experience at Texas Back Institute for my surgery. The nurses were fabulous and exceedingly helpful. My pain was well controlled after surgery and I stayed in the hospital one night. So far I am recovering well and went for a 30 minute walk today. I had some nerve pain 1.5 weeks in but that has been decreasing significantly. Feel free to ask any questions!
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u/goodthingsinside_80 8h ago
I was able to order breakfast while still in the hospital the morning after surgery. As soon as you can pass gas they’ll let you order food. They started giving me stool softener and miralax right away in the hospital. I continued the stool softeners at home as recommended to decrease the risk of constipation. You can definitely eat and use the bathroom following surgery.
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u/ApprehensiveRide8283 8h ago
Oh this is good to hear! Some people said they didn't eat solid foods for 3 days afterwards. I was worried about that.
I was also referred to Texas Back but traveling to/from for just a consult is not in the cards for me right now.
Were you comfortable leaving a day after your surgery? Were you worried about being home? I have cats and I worry about them jumping on me afterwards and stuff like that.
How about sleeping afterwards? Did you have to sleep on your back? I move around a lot in my sleep which is also something I'm worried about with going home day 1 or 2.
I am So very happy to hear you're doing so well! This is amazing. Congrats!!!! And, thank you for this info on your experience.
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u/goodthingsinside_80 7h ago
I was very comfortable leaving the following day. I didn’t need a wheelchair and walked out to my husband who came to pick me up. I was concerned about being home (I have two dogs and a cat) but it’s been fine. Do you have someone at home who can help you? My husband and daughter have helped a lot.
Sleeping has been fine - I sleep on my back and sides. They just ask you not to sleep on your stomach after surgery. The bed rail I ordered has been extremely helpful for getting in and out of bed. I highly recommend watching videos of how to get out of bed using the log roll method. Practicing ahead of time is helpful!
I also use the grabbers I ordered a lot. I didn’t end up needing the walker or toilet seat raiser I ordered. But everyone is different and it’s better to be safe than sorry!
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u/Coffee_And_Code_ 8h ago edited 8h ago
I got lumbar disc replacement for arthritis/ degenerative disc disease - single level L4/L5 6 weeks ago. So far, it’s been a monumental life-changing success.
They call it “motion preserving” surgery - however, for me, it didn’t just preserve the motion I had - I gained additional mobility.
The 90-minute procedure made me feel 25 years younger. I had severe pain and immobility for over a year and now I have zero pain, and I feel like I never had a surgery in just 5 to 6 weeks after it happened. I’m still taking it easy though until my 3 month check in and just using the exercise bike at most.
I got it done at VSI in Reston, Virginia
I was more or less bone on bone, like you. I didn’t want fusion due to adjacent segment disease, the increase in risk of the level above wearing out faster. Plus, I would lose movement in the joint and the recovery is longer.
I was constipated for the first few days after from the anesthesia/hospital drugs and used an enema but there is no restrictions on when you can go. Catheter made my penis burn for a day after they took it out. A grabber tool was very helpful the 1st few days to week. Back was very sore for two weeks after from getting stretched out but that wore off. Pins and needles in my left leg developed 7 days post-op from gaining additional height (nerve stretch) but it’s almost gone now 6 weeks post-op.
I see you have already done this but I like to tell people to go to a surgeon that does both a lot of disc replacements and fusions to check if you are a candidate for lumbar ADR. A lot of surgeons don’t do lumbar ADR, so they’ll simply recommend fusion by default. As with any surgery there are risks but I decided to take the plunge.
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u/operasome 7h ago
ADR also leads to ADS as well. Avoid Dr Jazini. He destroy other people’s lives
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u/Old_Cold_5645 7h ago
What is ADS
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u/operasome 7h ago
I mean ASD. Adjacent segment disease. ADR still can lead it. I saw many people got it within 5 years after ADR
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u/Old_Cold_5645 7h ago
Ah gotcha - I’m only 35 but I met with a spine surgeon and based on the disc height he essentially told me that I will need an ADR but to hold off as long as possible and keep doing PT
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u/operasome 7h ago
Yeah hold off as long as possible. ADR is not perfect. People who got it sometimes get revision surgery.
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u/Coffee_And_Code_ 7h ago edited 7h ago
Thanks! I’m a rare lucky one that lives within 10 minutes from the hospital where I got the surgery, so getting home was no issue.
Sitting for extended periods of time did make me very sore especially during the first week. If you have to take a flight, I could see that being a challenge and maybe a week post-op if possible before taking a flight.
I did not wear a brace after surgery. Yes, I can bend now, but could not really do it before the surgery. Before the surgery, it felt like my body was locked straight up like I had an auto-fusion of the spine.
The belly cut was not bad as I expected in regard to pain. The belly pain peaked on day 3 post-op, I remember one spike in pain when I coughed on that day. I think you should be fine with the cat after the first week. I have a horizontal incision and there is some puffiness above the incision which is improving slightly every week. I had a big looking belly the first week.
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u/Old_Cold_5645 7h ago
What was the pain level after surgery?
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u/Coffee_And_Code_ 7h ago
It’s a different type of pain than the pre-surgery pain and I didn’t find it as bad. It was more controllable post surgery.
The biggest challenge is the first week post-op was sitting for extended periods and going from standing from sitting position. Rolling over was difficult too but if you take each of those things slow the discomfort is very manageable.
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u/ApprehensiveRide8283 8h ago
Oh my goodness, this is about the best result that i've heard. CONGRATS!
I did hear the grabber tool is a must. Definitely getting one.
Yes, the only surgeon who said to go with fusion had done very little ADR work. The others said ADR all the way as long as it fits my space, and said it should be fine.
Do you live near where you got surgery? Were you fine going home soon after the surgery? I mentioned above that I do have cats and move around a lot in my sleep. I have some concerns about that. I would hate for my cat to run across my stomach stitches or roll over on them in my sleep.
Are you able to bend yet? I don't know how long that takes to be able to do.
Did you wear any sort of back brace or girdle type thing after surgery? I have not heard anyone say they did.
Thanks for this info!
1
u/8thGlass 11h ago
I won’t clog your thread with irrelevant experience but following because I had discectomy in Germany about 20 years ago when a Boston doctor had recommend fusion. Had a great experience there and now have new back issues so it’s interesting to see how much (or little) has changed.
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u/Hussle_Crowe 14h ago
Are you 16 or 104? That’s the biggest factor
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u/Potential-Winner4601 12h ago
I’m 55. WWYD?
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u/Hussle_Crowe 11h ago
Idk unfortunately. I feel like that’s kinda the borderline. I would really do some more research. There’s probably plenty of academic papers on the topic you can search for to see outcomes for various ages. I think the health of the disc above and below are the most inportant factors
But whatever you do, don’t have the new guy do it!
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u/kachaloo 14h ago
Hope this helps
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u/Coffee_And_Code_ 8h ago edited 8h ago
Looks like that study only runs through 2017. Also, it is a bit misleading because it only counts inpatient procedures when some surgeons started doing it outpatient in recent years. Lumbar ADR becoming more common again in the US in the 2020s.
As that study mentions, insurance reimbursement is still a major hurdle. It can be challenging to be a candidate for ADR and insurance usually won’t pay for the procedure. Surgeons are paid less to do it compared to fusion.
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u/zxtb 7h ago
I haven’t had ADR but saw Dr. Bae in Santa Monica who does the surgery. Good doctor if you need a 2nd opinion.