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Old 06-07-2013, 08:29 AM   #1
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Looking for L5/S1 Disk Replacement Feedback

Hi all -- wondering if anyone has had L5/S1 disc replacement surgery. I'm leaning towards disk replacement over fusion as I'm young (31) and the doctors all feel like fusion at 31 will mean another at 41, 51, etc....

But I've also heard that a lot of doctors won't even do L5/S1 disk replacements anymore since the risk of failure is so high....

Looking for any stories (success or failure) -- thanks all!

 
Old 06-07-2013, 12:06 PM   #2
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Re: Looking for L5/S1 Disk Replacement Feedback

Can't help you with ADR, but wanted to welcome you to the board. I am fused from L3-S1, but I had spondylolisthesis and severe stenosis, not a disc problem. My advice is to get a number of opinions from both orthopedic spine surgeons and neurosurgeons who limit their practice to neck and back. Do your research.

Other than perhaps in Germany, I don't know that we have much long-term data on how long an artificial disc will last ...they haven't been around all that long. And when there is a problem, the surgery to remove an artificial disc is considered life-threatening surgery.

My experience of hearing from people who have had ADR has been about 50-50% -- perhaps slightly weighted on the side of people who wish they'd never had the surgery. But when it works out, people seem very happy.

At the L5-S1 level I don't know how much is gained by having ADR as there is very little movement at that segment to begin with. The loss of motion from being fused would not be noticed by most people.

Is your situation so bad that you have to have surgery?

 
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Old 06-07-2013, 12:11 PM   #3
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Re: Looking for L5/S1 Disk Replacement Feedback

Thanks so much for the reply. I've seen 4 neurosurgeons at this point (seeing a 5th in a couple weeks!). The general consensus falls like this : too much damage to keep waiting and do nothing, fusion is drastic and permanent and at my age likely to need L4/L5 fused, then L3/L4, etc etc. So a couple have recommended the DR (a couple have said its not a good idea).

I have no idea who's opinion is right and who to believe. Trying to make sense of it all...

 
Old 06-07-2013, 04:00 PM   #4
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Re: Looking for L5/S1 Disk Replacement Feedback

It is confusing when you have various points of view. Before my first surgery, which was a fusion at L4-L5, I had opinions that ranged from a 3 level fusion...but he reserved the right to do 5 levels if he found it was needed, once he got in there...to one doctor who was willing to try a laminectomy first...everyone else said one level would resolve my issues.

I would suggest you get an opinion from a fellowship-trained orthopedic spine surgeon. Their fellowship spine training is extremely similar to the neurosurgeon's, but they tend to have different personalities and sometimes approach things slightly differently.

Regarding the need for more fusion in the future...it is called adjacent segment disease or adjacent disc disease...and it occurs in about 10% of the cases....and if there was a need for one fusion, I think it makes sense to think there may be a tendency to have issues with the adjoining segments, whether there is fusion or not. Of course we know that the adjacent segment has to do doubt the work after fusion, as it is now the first moveable part after the immoveable block that is the fusion. If one abuses the spine, this problem will be exacerbated -- but day to day, normal activity should not increase the risk all that much.

 
Old 06-07-2013, 04:22 PM   #5
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Re: Looking for L5/S1 Disk Replacement Feedback

Hi!
I had my S1 removed on April 22, a basket and hooks put in place. Basket filled with my bone and bone marrow. But, I am 54 and have had my entire thoracic spine fused due to kyphosis at 29. I feel a lot better, but am still recovering, I feel next to no back pain now and pain in my legs is about 75 percent gone. My surgery was successful, and I had a great doc. It was a long surgery as it was done both anterior and posterior and I had a lot of pain the first week or so. Doc says I will have more mobility once the basket fuses I actually feel like I have more mobility already! Good luck to you

 
Old 06-08-2013, 02:05 PM   #6
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I had Dynesys® Dynamic Stabilization System done several years ago at l4l5. That uses bolts instead of traditional fusion. Don't know if that is an option.

 
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