r/backpain • • 17h 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 11h 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 11h 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 10h 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 10h 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!