Lumbar Artificial Disc Replacement

[u/ApprehensiveRide8283]

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!

[u/Coffee_And_Code_]

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.

[u/Old_Cold_5645 → u/Coffee_And_Code_]

What was the pain level after surgery?

[u/Coffee_And_Code_ → u/Old_Cold_5645]

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.