Fusion or disc replacement L4-L5?

To besmith57,
Thank you for the comments.
Was the recovery painful, and is it a long recovery process?
Also, did you have a lot of out of pocket expense?

Sorry, to tell you, but the recovery was long and painful, but worth it in the end. If pain pills work for you that will help. They don't have any affect on me. I don't remember much or any out of pocket expense. The surgery and hospital stay was over $192,000. I was hospitalized longer because the surgeon nicked my spinal cord causing it to leak. Good luck to you!

After failed l4/l5 surgery and much older I can tell you this is not something to take lightly. First, be sure you are getting advice from a reputable neurosurgeon and do your research on them. Look at their google reviews. Check their record. If your not sure on their advice get a third opinion or a fourth. Pain is unfortunately always part of the process but be sure before you do surgery. Surgery should be your last and final resort not a first option.

Sorry for your troubles at such a young age.
As a young man and up to age 71 was very active. I played HS and College football, wrestling and LaCrosse. In football we played both ways. I also played Semi Pro football up to age 33. I was playing in a softball league in the 70's and hurt my back throwing from 3 rd base to 1st.
Anew years later I had a lamenectomy on L5.
After several months I was fine. I worked out and was also a power lifter, crazy heavy weights.
At age 71 my back became a problem again,terrible pain. I received injections for pain at 3, 4 and 5. I also had Stenosis I had surgery for Stenosis and the disc's. It lasted about 2 years and I was in pain again.The pain Dr gave me in jections again to no avail. He also performed surgery to relieve pressure on a ligament which was unsuccessful. At 84 years of age I had a 5 and 1/2 Fusion surgery which left me pain free. But I have a dropped right foot and Neuropathy from the pressure on my Spine for many years My balance is terrible and a go to PT 2x a week for Balance which isn't helping much . I use a Cane to walk.
My advice to you would be to have the Fusion Surgery to be relatively pain free for the rest of your life.
My second wife who is much younger than me has been through he'll. We like to travel but because of my limitations when we traveled I was a hindrance.
For the past 5 years I have been unable to travel to see my children , 9 grandchildren and 1 great grandchild.
They visit or use Whats Ap or Alexa because I am 1500 miles away.
I know I have been " Wordy ". But I thought my story would help you to decide your future.

In 2008, at the age of 52, I had an L3-4 artificial disc replacement (ADR). The thought at the time was that I would have less risk of wear and tear on the adjacent discs above and below because the artificial disc would allow some flexibility at that level while a fusion would not. At the time it was a new procedure and my insurance refused to cover the cost. I waited 7 months to be able to change insurance to a different company that did cover most of the cost, however, my portion to pay out of pocket was $9,000. I did not think the recovery was too bad but I do think I had good pain management at that hospital. I was back to work, including air travel, by 6 weeks. The ADR relieved my pain until 2019. At that point I did have severe degeneration of the discs above and below the ADR, resulting in scoliosis and constant pain. My surgeon then recommended a five level fusion. So, in all, the ADR worked for about 10 years for me. Everyone’s situation is different but I think most of us agree that any type of spine surgery should be a last resort because no matter which you have done it changes the mechanics of the spine and you may, but not always, set yourself up for more problems in the future.

Disc replacement surgery has advanced both in technique and in the discs themselves.
https://centersforartificialdisc.com/artificial-disc/low-back/the-latest-in-lumbar-disc-replacement-technology/#:~:text=Prodisc%C2%AE%20L%20Disc%20Replacement&text=The%20Prodisc%C2%AE%20L%20Artificial,and%20rotating%20on%20all%20axes.

Oh, how terrible. I am so sorry this happened to you. I have had 7 spine surgeries during the last 5 years for degenerative disc disease, 9 total in my life. Adjacent disc problems, now called proximal joint failure, are no joke. I have had neurological
issues after 2 surgeries but I was able to do PT long enough to make the effects on my quality of life negligible. As of June 2024, I am now fused from C2 to my sacrum. I have some limitations with the stiffness but no pain. I feel very fortunate. Your story is cautionary for anyone considering spine surgery. I hope your quality of life has the potential to improve over time.

@dlydailyhope Hi I’m wondering if you encountered lots of back pain issues after surgery? My husband will also go through decompression and fusion of L4-5 in a few months due to instability. Are you satisfied with your surgery result? Thanks

@ljc50
I am so far glad I did the surgery in L3-L5 to decompress and fuse those levels. I had L4 slipping over L5 and severe stenosis at L4-L5 causing significant neurogenic claudication symptoms (pain/weakness and numbness in lower back, hips, buttocks, thighs and into feet on both sides). After the surgery, I have improved significantly and pain has reduced and numbness and weakness has also improved. I have new hip flexor nerve pain after the surgery and not sure if this is from nerve regeneration and healing from being compressed over 10 years. That is my hope. My understanding is it can be a full 6 months to a year to fully heal from surgery to determine the full effect of having surgery and if symptoms improve or go away. I have some stiffness and some reduced range of motion but glad I did the surgery even though it was extremely painful at first. I’m glad I got the surgery when 55 and I did not wait any longer. I am not sure I would want to try to recover when older. My recommendation is to get as fit as possible before surgery to help with recovery after surgery. Physical therapy would be good to help strengthen core and back/leg muscles to support new movements after surgery.