# Back operation / disc replacement?



## The Hedgehog (26 Jan 2009)

and I'm not talking about your brakes.

After several years of increasing lower back and leg pain , I took the decision to have my S5/L1 disc completely replaced by way of an operation called TDR (total disc replacement). The operation involved removing my 'old' disc (which had been worn thin) via the front (stomach) and having an artificial disc inserted. This was very recently. I haven't yet been back on the bike and probably won't yet for a couple of months.

I'd like to hear from anyone who has had this done, or maybe a spinal fusion, or knows of anyone who has had this done. How is it riding a bike or doing other routine activities?


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## zimzum42 (26 Jan 2009)

having just had three herniated discs I am still recovering. Would also be interested to hear what people say about this cos apparently I may need this done some time....


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## beancounter (26 Jan 2009)

I'm trying to avoid this, although an MRI scan revealed that my bottom two or three lumbar discs are shot to hell. Surgery as invasive as this scares the hell out of me.

I put my faith in regular chiropractic and naproxen/diclofenac.

And I never lift anything bigger than my cat. Ever.

bc


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## peanut (26 Jan 2009)

I'm dreading the time when I'l need the same op. L5/S1 has disintegrated leaving vertebrae rubbing. 
My girlfriends Son had his fused at 21 yrs of age and it did take some time to heal and regain fitness . He was a flat race jockey .He can still ride out 4-6 lots a day on the gallops now which is pretty tough on a spine. I would say it took 4-6 months before he regained 3/4 strenght and mobility but his back was still vulnerable to spasm and pain for some time after.


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## numbnuts (26 Jan 2009)

I had an laminectomy (spinal fusion) way back in 1989, things may have got better now, but I was left incontinent, so ask your butcher I mean surgeon what are the possibilities being left the same. My incon is sort of under control now, but still have to take precautions at night time and when I get pain in lower back seems to bring it on again.
Sorry to be all doom and gloom, but as I said mine was a long time ago.
Good luck
Ps my user name will give you a clue to how I was left


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## peanut (26 Jan 2009)

thats the big risk isn't it. Sorry to hear your op didn't go as it should.
The more I read the more clear it becomes that surgery really is a last resort. The odds are amongst the poorest in all surgery types as far as I can see. There is so much nerve and blood vessels than can be damaged leaving permenant disabilities pain and other problems I will only consider surgery when I cannot stand the pain or have other severe problems that make life untenable.


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## The Hedgehog (26 Jan 2009)

Thanks for the replies.
Surgery really has come along way. I too saw this as a last resort and tried everything else...endless physio, acupuncture, steroid injections to the spine etc etc. Yes, the odds aren't brilliant - they quote 70% as a figure of people who report an improvement post op, varying from completely out of pain to minor improvements. There are still other risks which are very slim in chance but worth considering (e.g. 0.5% chance of becoming infertile). I had reached a point where the back pain effected my lifestyle so much (I'm early 40's) that I had to do something. 

Its very early stages for me. The operation so far seems to have been successful in that alot of my pain has gone and there were no major complications. I absolutely dreaded the operation - first time in hospital for an operation etc, but looking back on it I don't know why i spent the 4 months leading up to it in denial about it and refusing to believe that it was actually going to happen. The worst bit was the 10 mins prior to being put under. Despite the best efforts of the anaethnatist to lighten the situation, I was having seriously crapping it. The best bit was coming round, in no pain at all and ready access to the morphine drip! I spent 3 days in hospital. The post op bit in hospital really is not a reason not to consider it.

One alternative to TDR is the spinal fusion. The recovery for this is far longer and some mobility is lost. It seems there does reach a critical point when the vertebrae are too close together (ie the disc is so shot) that a TDR is not possible. Mine was touch and go & I'm glad it was not a fusion as this seems very scary. By the way, this operation is only performed in a few hospitals around the country.

Hope this helps anyone else considering it.


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## andy_wrx (26 Jan 2009)

I had L5/S1 replaced at end of May 2006. 

Apologies if this is something of an essay, but I hope it's useful : I know how I felt immediately post-op, worried if it was the right thing to have done, rather committed and concerned about the consequences. 

My back went in December 2004, aged 41. Ruptured disc L5/S1. 
I went from running marathons and cycling centuries to not being able to run at all, restricted mobility, constant referred pain down my right leg to the ankle and the inability to sit in a car for more than 20 minutes without pain that got progressively worse the longer I was in the car - I was literally screaming one day when caught in a traffic jam and one plane journey was 6 hours of hell. 
I could still cycle, that position didn't seem to bother it anything like as much as sitting, but I'd had to cut-down distance and speed. 

I had the ProDisc artificial disc implanted - my surgeon said he wouldn't use the Charite replacement disc, as he considered it didn't have a high enough success rate. 
The problem though was that whilst through work I had BUPA, BUPA would not cover the ProDisc, although they would cover Charite (AXA, PPP, etc would do both...), so my surgeon had to put me on his NHS waiting list for the op. 
And whilst I saw the same surgeon and am sure the quality of the operating room staff etc was top-notch on the NHS, the follow-up was not : I was discharged with one spare dressing and a first appointment with a physio 4 weeks after the op ! 
So I got back on the physio program with BUPA a week after the op, although the physios said I should have seen them sooner... 
- so my first tip is, if you're not seeing a physio, a physio who is used to disc op rehab, try to get there asap because they reckon just after the op is the critical time where you can regain, or not regain, so much. 

I was told **something like** 
- week 1, limited time in a sitting position in a good supportive chair, short walks 
- week 2, longer sitting periods, longer walks now maybe upto a mile (Jeez - obviously short in week 1 meant short !) 
- week 3, longer again 
- week 4, gentle cycling can start 
- week 6, driving and back to work 
- 3 months, running 

I pushed this. 
I was doing 1 & 2 mile walks in week 1, up to 4 miles in week 2 and then found I'd done too much : didn't collapse or anything, but was overcome with weakness & dizzyness and had to sit on a wall before walking back very gingerly and slowly. 
So I backed-off a bit and then started upping it a bit more carefully. 

I'm now not sure if this was the back op or maybe after-effects of anaesthetic, but I definietly felt poor after the op but over the next few weeks this improved. 
It was Summer for me, so being off work and able to go out for walks in the sunshine was a major tonic. 

My back felt sore, weak, strange, even a bit scary. I had a rather more lower back pain than I was used to at this stage, but far less of the referred-down-the-leg-to-the-ankle stuff. Any stumble or jolt to my back was a bit scary but nothing nasty actually happened. I was also worried about bursting-open my stomach wound (maybe 2-inches or so, vertical, between pubes and navel). 

I was seeing the physio a couple of times a week and doing lots of strengthening and mobilising stuff, basically very happy to be able to raise my right leg straight for the first time in several years. 
The physios were trying to reign me in, telling me to take it easy and not overdo it, stick to the schedule, but they admitted that I wasn't the first previously fit&active individual they'd had who they'd had to reign back as soon as they'd had the op. 

After 4 weeks I got back on the bike on the rollers for a couple of miles. I figured that if anything happened, I could just stop, wouldn't have to walk back home. 
No issues, so upped it to 5 miles or so and then out on the road. 
Even though I live in rural Cheshire with little traffic, I was scared absolutely silly of coming off the bike by going out on the road on gravel or being clipped by a car, was very nervous of jolting over potholes, but everything was OK and I was up to 20miles by week 5. 

I was just down to ibuprofen now and after 6 weeks I was cleared to drive and return to work - office based, not a heavy job : given strict instructions about sitting properly and not slouching, for no more than 30 minutes without getting-up and moving around, etc. 
This went OK although I was pretty tired initially. My company were very supportive and let me leave a bit early for the first couple of weeks. 

I managed a century 3 months after the op and started back to easy running, then after 4 months we went walking in Scotland. 
Since then I've just carried-on stepping it up and now have 'a normal life'. 

I had been told at the time of the op that it would take 2 years for my back to be at it's best - it would keep improving for 2 years, then what I had after 2 years is what I'd end up with. 
It didn't feel like it, but they were right. 2 years is a long time, the changes and improvements were so slow and subtle that I didn't really notice them at the time. 
But I keep a training log anyway, so I've filled it in with what exercise, physio, stretching, etc. I've done and when pain or discomfort stopped me - it's clear how much the improvement has been, and how it was so slow and gradual. 

I still have referred leg pain, probably more than 50% of the time - but it's now mostly more of a background irritation and I'm only really aware of it when it's bad enough for me to notice, if that makes sense ! 
It causes me to adjust my position, get up and move about. It can be a problem if there's a lot of travelling, or in strange chairs, but it's manageable. 
I take the occasional ibuprofen, but it's when occasionally necessary not all the time - a Transatlantic plane journey was fine with a few ibu's. 

I used to do a lot of stretching anyway, but have found I need particularly need to stretch my sciatic nerve and hamstrings. I ought to stretch daily, but don't. I did attend a pilates class for a while and found that useful, I now do it on my own at home. 

Running started-out difficult, got better, is now OK. It does irritate my back and I need to do stretching or cycling to put it right again afterwards. 
Consequently I'm not back to where I was, but my wife runs too and we have lots of friends in the running club, so it was important to me to get back into it. 
I don't think I'll ever run a marathon again but I did a favourite Half a year ago and then did it again last weekend only a couple of minutes off my pre-back course PB time from 4 years ago. 

Cycling seems to help. I reckon it loosens something, by rhythmically massaging/stretching something. I try to cycle every 3 days or so max, even if it's just half an hour on the rollers, although getting out in the fresh air is better for me mentally I think. 
Sometimes I'll not get out on the bike for a week and by Friday my back is really nagging away at me, I'll go out on the bike on Saturday and it'll be a twinge down the leg with each pedal stroke, but after 20 minutes it'll have eased and I'm OK again. 

Doing less running, I've switched-over to more serious cycling. 
I did 4 sportives in 2007 and 2008, had a week in Provence including an ascent of Ventoux - I'm currently getting my velodrome accreditation and doing Fred Whitton in May. 
My back does bother me after a sportive - I'll be in pain for the rest of the day and definitely on the ibu's, but they are pretty tough and I'm not sure what state I'd have been in after one 'pre back'... 

So do I regret the disc op ? 
Simple answer is No, although there is a nagging worry that these things are not long-term proven and I don't know where I'll be with it in 30 years. 
But I went from being a fit&active person to being a not-at-all-active person in a lot of pain and discomfort, prevented from doing all sorts of things, and I found that very difficult to cope with. 
I wouldn't recommend a disc op to anyone, I think it's a seriously major thing to have done, and it's irreversible : my surgeon said that all sorts of therapies like chiropractic, accupuncture, painkillers, steroid injections, pilates, etc may help and if they do great, if they don't then they do no long-term damage, but a disc op, be it a replacement, fusion, or whatever is risky and irreversible. 
So it should be done as a last resort, if someone has tried everything else. 
But for me, I'm glad I had it done. It's not got me back 100% to where I was 'pre back', but I'm hugely improved and it's got me back to somewhere I'm a lot happier to be 

I hope this helps. 
Good luck with yours.


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## MrRidley (26 Jan 2009)

Back in august i had a spinal op consisting of 6 titanium screws being inserted into my spine along with approx 1 meter of wire, the op was needed because i had severe back and leg pain for years and the doc decided enough was enough, the op involved jacking up the bottom two discs (same ones you mention) as one was lying on top of the other, after the op i spent two months off work and had to wear a support brace for this time, i was advised to stay off bike for 4-5 months however i was back on in december gradually easing myself into it, now i am doing anywhere between 50-100mls per week and feel great, it is inactivity that i feel causes me problems like stiffening up if i sit about for to long, as i say i'm now back at work doing my job as a storeman with no problems at all, i see the surgeon every couple of months and he is advising me to keep the cycling going as he sees no problems, i think it is down to what type of person you are and what age that the recovery speed comes into it, i only wish i had it done earlier.


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## zimzum42 (27 Jan 2009)

Andy, thanks for posting that, useful stuff. I've not had the op, but the recovery seems similar to what I'm doing, so it's inspiring, and even moreso, I want to do everything right so i don;t have to have the op!


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## The Hedgehog (27 Jan 2009)

andy_wrx said:


> I had L5/S1 replaced at end of May 2006.
> 
> Apologies if this is something of an essay, but I hope it's useful : I know how I felt immediately post-op, worried if it was the right thing to have done, rather committed and concerned about the consequences.
> 
> ...



Thanks - I responded on the bike radar forum - many thanks


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## The Hedgehog (27 Jan 2009)

bhoyjim said:


> Back in august i had a spinal op consisting of 6 titanium screws being inserted into my spine along with approx 1 meter of wire, the op was needed because i had severe back and leg pain for years and the doc decided enough was enough, the op involved jacking up the bottom two discs (same ones you mention) as one was lying on top of the other, after the op i spent two months off work and had to wear a support brace for this time, i was advised to stay off bike for 4-5 months however i was back on in december gradually easing myself into it, now i am doing anywhere between 50-100mls per week and feel great, it is inactivity that i feel causes me problems like stiffening up if i sit about for to long, as i say i'm now back at work doing my job as a storeman with no problems at all, i see the surgeon every couple of months and he is advising me to keep the cycling going as he sees no problems, i think it is down to what type of person you are and what age that the recovery speed comes into it, i only wish i had it done earlier.



glad to hear some very positive news - I hope it continues to go well for you and that my experience is as good as yours.


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## Mickey_Mouse (13 May 2010)

The Hedgehog said:


> and I'm not talking about your brakes.
> 
> After several years of increasing lower back and leg pain , I took the decision to have my S5/L1 disc completely replaced by way of an operation called TDR (total disc replacement). The operation involved removing my 'old' disc (which had been worn thin) via the front (stomach) and having an artificial disc inserted. This was very recently. I haven't yet been back on the bike and probably won't yet for a couple of months.
> 
> I'd like to hear from anyone who has had this done, or maybe a spinal fusion, or knows of anyone who has had this done. How is it riding a bike or doing other routine activities?



I had the disc at L5-S1 replaced on the 20/4/2010. Was in hospital for 4 days. Did suffer of spinal leakage due to morphine injection into spinal column during surgery. This caused high blood pressure for +- 12 days. The recovery would have been better if I could have walked more during this time but had to lie down else my head would burst from the pressure. The most painfull has been the stomach. Normal bowel movements are difficult and gas and bloated stomach still common after 3 weeks. Sneezing and coughing painfull where the cut was done. As for back pain, totally gone. I suffered from leg pain & numbess down the left leg when cycling. Will start training on the 1st June on indoor trainer for 2 weeks then get onto the road. Hope that the symptoms will be gone. Sleeping without pain pills is a plessure. Had lower back pain for 20 yrs (I am 48yrs). Leg pain for the last 3 yrs. Had 4 rhizotomies, the first 3 helped and lasted for 4-6 months. The last rhizotomy didnt work at all. I thinks success is determined by your surgeon making the right diagnoses. If he replaces the wrong disc. Well not going to help a lot. So will post here again once I start riding.


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## arallsopp (21 Jul 2010)

Howdo. Another one here to chip in with a (mostly) positive result.

Early 2008: S5/L1 disc herniated. Lots of pain. GP says "take these painkillers"
Six weeks later: Disc collapses. Vertebrae rubbing together. Leg hurts. GP says "take *these* painkillers"
July 2008: MRI shows vertebrae fractured. Splinters in the spinal column. 
25th July 2008: Appointment with consultant. 
26th July 2008: Emergency Op. 

[there follows a short period where I learn to walk. Sneezing nearly kills me. Special loo seat required. Not quite as watertight as once was. Everything hurts.]

it gets better.

26th July *2009*: Ride LEL on a recumbent.

IMHO, you're doing the right thing. Get it looked at. Get it treated. Be aware of your limits. Act accordingly.


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## socalGeezer (8 Nov 2020)

As a cyclist with back issues, I appreciate the entries in this blog by folks relating how their back issues is/have been dealt with. 

I was a hard core road cyclist for years but in 2012 the pain in the vicinity of L4/L5 became too great. I sucked a few more years of exercise by putting a spin bike between two upright gym bikes so that my torso was vertical and a lot of my torso weight was on my elbows. By this year (2020) even that had become prohibitively painful. To me it appears that when unloaded, the L4/L5 disc has sufficient height, but when loaded, it collapses and I get a lot of pain. All along I've had MRIs and seen orthopods, but because the MRI shows a disc at full height, they never want to do anything.

I had a discogram and then artificial disk replacement in Germany (Dr. Bertagnoli) this year. The discogram showed the disc was shot -- it didn't hold any pressure at all. A month after the disc replacement, I'm doing fine. The initial emphasis is on walking although I've done a little light-load spinning. Almost no pain. The disc used is the ProDisk L which appears to be 'a' if not 'the' favored disc for lumbar ADR.


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## socalGeezer (8 Nov 2020)

andy_wrx said:


> I had L5/S1 replaced at end of May 2006.
> 
> Apologies if this is something of an essay, but I hope it's useful : I know how I felt immediately post-op, worried if it was the right thing to have done, rather committed and concerned about the consequences.
> 
> ...




How is it going now circa Nov. 2020?


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