No doc here, but had some major disc issues L4-L5 and L5-S1.

I would hold off on surgery and replacements, if you are doing all sports and all normal activities but only with pain. If you are cripple, in bed, or in a wheel chair, then that's another matter.

Ask the doc if they will do it for free or in other words would the doc do it if there was zero financial upside for him/her and only work to make you better. If this is the only option left (full replacement) and there is no money involved and that's the best solution, then fine. But I bet it is not, only because you have not said you are cripple and cannot do anything.

Paul. I am in extreme pain and went from ready for Ironman Santa Rosa At the end of July to... some leg pain and loss of flexibility ... and then did 38 days on 3 fires here in California with progressively worse pain the whole time. Once home it got worse and worse. I am at home with a back brace and walk one mile a day now. Tough to get out of bed. Supposed to get a shot this next week or the following. But the Dr doesn’t feel this will help At all.

Also not a doc but have suffered with issues with both the L4/L5 and L5/S1 on and off for many years. It's been excruciating at times, and other times it goes away entirely. I don't know anything about your specific case, but IMO surgery is the option of last resort unless the pain is debilitating. I'd try anything/everything else before that. I've had good results with Chiro/ART/Graston, PT, and most recently epidural cortisone injections. Working on core strength and posterior chain strength (lower back, glutes, hamstrings) is key for me.

Total disc replacement is uncommon in the US. Only a few places are doing it here. More common in Europe. Insurance would rather pay for a fusion. Who is going to do the disc replacement, and has your insurance said they will cover it. How old are you?

Thanks El Gato. Once I was told my pain was from my back and not hip or lag pain I stopped all workouts do to fear of hurting it more.

Tom

Work injury ... replacement is common for this highly recommended ortho group that does work for the high end athletes around here (Sierra pacific Ortho in Fresno CA) . I just want to return to my July life. Best shape of my life. Now it is hard to sleep and function in the Am.

Sorry to hear about this. I agree with El Gato on last option through and I would just park any discussion of triathlon and Ironman momentarily and get back to all normal people stuff pain free first. What can you do with non surgical interventions first though? There are many. I personally went through a 5 year journey, but because of the Canadian medical system I was waaaaaay down on the surgery list because otherwise I looked like I was not a pathetically helpless person who needed to be whisked to the top of the surgery list (or a pro hockey player). So in the mean time, I had to just chip away slowly. But you may not have that patience and a surgical option may accelerate things so its not a multi year process. But it can be worth the long haul approach.

I still have a variety of pain and limitations running, but I can do everything. I have not ventured up to an Ironman but sometimes I think I may want to try one in 2021 since my run volume in 2020 has been solid after a multi year hiatus. Once I was able to start jogging again, things really improved quickly.

Paul.

Yeah if I said go I could probably have surgery in about two weeks.

I don’t want to fight things for five years if surgery will fix me and get me back to where I was.

That being said if surgery may not be the answer and it won’t be a five year fight I am good with non surgical and putting in the work.

I've had the "should I have surgery" discussion with my Chiro and PT many times. They say they see just as many people that have had surgery and are just as bad off afterward as have had improvement. Surgery is no guarantee of improvement. I would definitely try an epidural injection and some PT first to see if that helps.

Gato

Yes that is my first plan. Just trying to talk to others that may have had the replacement

So I have been suffering for the past 8 plus years with bad low back and nerve pain, after a dozen epidurals or so which basically did nothing and 3 rounds of stem cell treatments back in 2018 I ended up with a discectomy this past February. My disk is collapsing and the nerve damage is from where an IVC filter ruptured into the disk and nerves which started back in 2012 so I know what's its like to suffer believe me, the doctor told me that after the discectomy the next step would be a disk replacement but I finally got some relief from the February surgery which for now allows me to ride the bike, only got up to 30 miles, no swimming due to Covid19 so not sure how it would work for that, also do lots of walking last month walked 152 miles. The doc is in LA and is one of the best spine doctors around.

So as for the disk replacement what scares me the most was when the doc explained the surgery how they go in through the stomach and open you up that way, but if I needed more surgery that is the way I would go, wouldn't get a fusion too many complications with hardware for me, I know a few people who have had that without much success. I would really try some other surgery before going the full disk replacement though, best of luck with your decisions it is not easy for sure and only you know. Cheers LA Rob

Copy thanks Rob.

Yeah my disc I was told is bulged so far if they do a discectomy there won’t be much left. Praying the shot does something

I had my L5 S1 gutted and removed a grape sized rupture in 2008. I ran a marathon late June and was limping in October due to nerve damage.

Post surgery the berve pain very slowly decreased. I do have permanent atrophy and so.e twitching in my right leg.

About a year later I was back with about 30 secs of my 5k pr but could tell running alone was not a good option.

I moved to tri in 2012 and did IM WI in 2014 in the shape of my life but the back thing though better still not great.

Ever since I only ride and as it sits I almost forget about my back age 43. And I am at 20,500 miles ridden year to date for 2020 and again in the shape of my life and not at all easy to beat by anyone pedaling bikes :)

I would try to get a second opinion amon the particular proceeded but with radiating pain it sounds like surgery is likely the correct path.

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24 Hour World TT Champs-American record holder
Fat Bike Worlds - Race Director
Insta: chris.s.apex

Thank you Chris.

So what did they put in place in 2008? Or they just did a big discectomy?

Disceptomy yes sorry. It was and still is essentially paper thin.

Like many others I tossed thousands of $$ in my case wastefully at chiro and PT. Once its a big nerve impingement its hard. Certainly wish you all the best.

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24 Hour World TT Champs-American record holder
Fat Bike Worlds - Race Director
Insta: chris.s.apex

Copy thanks Chris. Yeah the bulge is on s1 and s2 nerve root.

All these arm chair specialists advising you on what you should and should not do, despite very few actually having any experience with your unique pathology.
When I say unique, you can describe on here your symptoms and what the doc and scans show but it only paints a portion of the entire picture of your actual pathology and why surgery may be recommended.
I am a gas man and work regularly with a very very highly regarded pain specialist. Yes we see failures from back surgery but often those failures are in patients who are very high risk at falling into a long term destructive pain situation from the outset. What I am saying is that there are often warning signs that surgery may not be the best first option in that particular patient.
Whenever a thread goes up on here about back pain the usual stuff comes out about using it as a last resort and only after you have tried physio, chiro, graston and whatever other technique that person may know about. I can assure you 99% of the responses have no proper medical knowledge and are not qualified to assess your background, symptoms, scans and potential therapeutic options.
Generally all the surgical versus non surgical options have a role in certain circumstances but it annoys the f$%k out of me that whenever a back pain issue comes up all the armchair specialists just tell you to avoid surgery at all costs when they really have no proper idea about what they are talking about.
Dev's comments about whether the surgeon has any financial gain from the surgery is BS.....assuming you are being operated on in a private system of course they have financial benefit, as does your chiro and anyone else you see for therapy. No one in the private sector will go in and do an operation for free.....no one who assesses you and manages you will be doing it for free. What Dev may be getting at/confused with is does the surgeon get an additional payment from the device company for using their specific disc replacement. This is where things get very very murky and in the system I work in (Australia) is likely less prevalent than the USA, but is full of potential pitfalls.

Thanks Amnesia. It is all taken with a grain of salt and in reality what I asked for was for someone that had a disc replacement and what it was like after which none have that have responded yet. I appreciate your feedback as well.

My only point is that given this guy was in full blow IM fitness and suddenly went downhill faily quickly I would question if a full on replacement is needed as the first option. Of course whether it is a plumber, dentist, lawyer, accountant or carpenter, it is alway wise to ensure that the practitioners financial upside is not clouding the resolution options too significantly. its not like medical professional are immune towards being affected by what we are all biased by (financial upside), but hopefully the option being suggested is the absolute best option which most professionals in most industries lean towards anyway.

In terms of armchair opinions, for sure, most will not be medical types, but ideally athletes who are medical practitioners, or affected athletes on the receiving end of medical care. If someone comes on ST to talk to other athletes about their experiences, its not a waste. At the end of the day you have to rely on your medical team, but hearing what other people have been through in our athletic cohort may be useful data points. It has generally been really useful for me, having a breath of data points dealing with medical staff who may or may not understand our lifestyles and desires. Its just sources of data. Don't get pissed off at people volunteering time to share their opinions (they are just opinions) but I have found these opinions to be valuable when going and dealing with medical staff. If I listened to some medical staff, I would be in a wheelchair for life, never run again and probably not walk. Other medical staff had different opionions which was corroborated by experiences of some athletes on here. But if I listened to the first ones right away, I would have a different view.....keep in mind that many success stories they never see again, My original doc who said I would never walk, never run, he does not even know that I am not in a wheelchair. In many cases when we beat what should not be possible its not even logged anywhere in the medical system....but on here, I have communicated with many that beat all types of odds with less aggressive therapies. So it was not a complete waste of time. Sometimes the encouragement on trying different paths can also be highly helpful.

But why dismiss the experience of others. Its just input. Posters have to decide for themselves what to do. Posts on forums are worth the paper they are written on. Its not peer reviewed published conclusions for sure.

This means absolutely nothing and only just confirms what I was talked about in relation to armchair expertise.

In terms of dismissing the experience of others....you are correct that posters should decide for themselves what to do. However, well intentioned individuals without appropriate experience can still steer them down the wrong path as they simply do not have the experience to actually know the differences in pathology and rationales for various types of management. The poster themselves may then end up very confused as to what they should do and potentially delay more appropriate management.

Anyway, the poster asked for experience of people who have actually had a disc replacement and my comment still stands....am waiting for someone to reply that has actually been through this for similar pathology to the OP.....

Once the nerve is compressed surgery is the definitive cure. Other treatments just move that option to the right for a little while. What kind of surgery is up to you and your Dr. but at the end of the day you can either suffer or have surgery. Its your call.

Fair enough, the poster asked about disc replacement, but this is only potentially 1 solution to his problem. But his problem is likely similar to 1000's of posters who have been through this in some capacity. The other solutions may or may not work for him. It is his choice to go in armed with the diversity of N=1 experiences and discuss with his medical team, but I would be less inclined to summarily dismiss the cumulative experiences on here, as they provide a sample breath from a cohort doing what he does, and in general the medical world does not have a great sample breath of people doing SBR at a high level for 140.6.....so its up to us to take what we get from others and then decide with or without medical staff (sometimes medical staff are somewhat wrong too). At the end of the day, each of us lives inside our own body so we have to live with our decisions.

I had emergent back surgery in 2016 due to herniated L4-5 with foot drop. Currently the 30 percent of that disc that was left has herniated causing leg pain. I made it through 5 ultras and 2 iron mans between these injuries, can’t say it was the smartest thing to do. I have given up my running and found swimming full time and doing open water events is what I really love, ive never felt better. If you continue my advise is to do lots of PT work and listen to your body.

Not sure who you're referring to as an "armchair specialist". It seems to me that everyone that has replied so far has gone out of their way to preface their remarks by saying that they're not a doctor, and are just sharing their experience. I don't know why this is so annoying to you. You know what annoys the f*&% out me? Doctors that expect you to take their word as gospel.