r/SpineSurgery

Is there a reason to plan for a disc replacement to avoid facet joint arthritis?

29F, I got my MRI report back today and everything looked normal for my age with the exception of this:

C3-4: Small broad-based disc osteophyte complex mildly narrowing the left neural foramen. There is no central or foraminal stenosis. The facets are unremarkable

Obviously I know it’s nothing to jump on right away and just manage through PT, posture, and avoiding certain activities. I was wondering if I should monitor just in case I should go for a disc replacement before any arthritis sets in the facet joints. I’ve heard you can be denied ADR if you have too much arthritis the facet joints. I worry about the load being shifted to those joints over time. I don’t want to get a fusion if I can avoid it. I also worry about adjacent segment disease as well. I can post pictures if anyone thinks that would be helpful.

I’m 26f and this is what it says:

Mild right foraminal narrowing at C6-7. Left foramina not well assessed due to positioning. Mild reversal of lordosis centered at C4-5. Spine posterior aligned. Cervicothoracic junction visualized. No focal prevertebral soft tissue swelling. Mild degenerative changes at C7-T1 and T1-2.

I’m so scared and my neck hurts so bad. I’m terrified of paralysis or the pain never going away or getting worse. What do I do??

I am 66 yo California resident. I had L4-5 Laminotomy and I am told I have DDD all over and ADR is not indicated in my age and spine conditions. Pain is still there but reduced. Got offer to have 4-level ADR in Dubai with costs probably >$150K. Can anyone share recommendations if they went through similar surgeries in Dubai or Europe? Can you be more specific about conditions before and after, which doctor, and costs? -Did anyone with similar circumstances get such operation successfully in US and paid out of pocket? - I am finding California doctors reluctant about ADR unless it is cervical because it’s less risk and easier relatively to replace from the front. The name of the German doctor in Dubai has been on this list before.

I’ll be having an ACDF of C5-C7 in October. How do you guys do it? I keep thinking what if I wake up and I’m paralyzed. I have the absolute worst anxiety that my doctor won’t treat me for. I REALLY don’t want to be paralyzed. The thought of my neck being cut open makes me sick. I just can’t wrap my head around it. I know I need it but I’m so scared.

27 F. I had a C5-6 disc replacement about a year and a half ago. I am just realizing there is a massive risk of developing osteolysis from the PEEK coating... Does that mean I am way more likely to have to undergo a fusion since it has such an accelerated osteolysis rate? I am so devasted ther surgery was so difficult to heal from and I expected it to last 15 years or longer :(

So I had this done on 8/3 following about three days of intense neck pain and right shoulder/arm pain. Some numbness in my right hand and on day 3, the arm weakness suddenly occurred when I woke up and couldn't get my arm up to brush my teeth.

So I went to the ER, got imaging showing the disk were herniated and just bad shape overall.

Surgery was completed on 8/3 and mind you have had a total knee replacement, multiple bladder surgeries related to an accident/attack. Post op pain wasn't anything like this. It feels just as bad as it did pre op sometimes even worse. Especially when I wake up I sometimes need help just sitting up.

First follow up is this coming Tuesday so I'm really just wondering is this pain level normal? They gave me 10 2mg hydromorphone for pain. I've used 3 just to try and get some sleep.

Pain is bad enough I can't straighten up my neck fully nor bend more than maybe an inch left/right up/down without the use of the pain meds.

Wondering if this is expected this first week or so or should I have someone take me to the ER cause this doesn't sound normal?

Hey all

I've had lower back disc bulges, herniation, and ddd for over ten years now. I've successfully managed to maintain a mostly pain free and active lifestyle.

One thing I've noticed is that glute/hamstring work gets into my back which then needs a little babying (it gets tight in response. I heat and continue stretches during this time) and make sure I give myself adequate recovery time between leg day.

I've had to slowly work my way from yoga to lifting weights with a gradual increase in intensity and load, for example.

Recently, I was diagnosed with a hip labral tear and during the course of rehab, I was told to do isometric single leg bridges daily. After about a week of this (and declining reps, tbh, maybe I should have paid attention to this!), I exploded in pain around my sit bones which has localized to my back (with accompanying stiffness).

All this to say, I'm now in a little bit of a chicken-and-egg situation between my hip and spine.

I'm learning all I can about surgery in both areas, and so here I am asking for a 101 on spine surgery. I've done a little reading in this subreddit and don't see any pinned posts, so thought I'd ask:

What's the difference between an orthopedic spine surgeon and a neuro spine surgeon? Do they typically offer different surgeries? What are the typically surgery options where discs are involved in the ways I mentioned (bulging, herniating, ddd).

Admittedly, I haven't learned a ton about this stuff in all this time, because I thought I was managing just fine! Now I'm wondering if my back is holding up glute strength, and whether I should look at surgery options at this point so my glutes can do what they need to better manage my hip labral tear (it's a small nondisplaced superior anterior tear, and I'm not sure I want to pursue arthroscopy for it). This recent flare has me wondering and I'd like to understand the basics as I proceed.

I met with my neurosurgeon today and I’m set for October 5th 2 level ACDF of C5-C7. He said I have a higher chance of being paralyzed from the surgery since my neck is so bad, but he’s confident. I’ll have to stay the night in the hospital for the night to be monitored. I have to stop smoking tobacco or he won’t do it, so I’m quitting today.

How was your ACDF? I’m terrified. It needs to be done though so I’m trying to stay positive!

Was rushed into surgery by a surgeons pa. no communication between the surgeon and pa. First surgery date surgeon minutes before surgery they canceled it. Surgeon said they didn’t know I had an infection and was on antibiotics. They prescribed the med and during pre surgery appointment I brought it up that I’m on antibiotics. Pa said it’s fine. 2 weeks later rescheduled. They want to do a fusion s1-l5. 10 minutes right before going into the or the surgeon changes it to laminectomy. they don’t see that it’s that bad on my mri. 5 months now post surgery and no improvements. Worse after it. Post mri shows 0.3cm spine canal opening after surgery. surgeon doesn’t want to help anymore. Never wanted to in first place. Said i never had spine infection after but i was on antibiotics for 3 months. Post mri showed big sack of fluid, lots of drainage from incision. Now I can’t walk, lots of pain and very bad leg spasms. they move on their own (uncontrollably) and no feelings in my legs. Is been very long rough road with no end in sight. Then to add I’m in rehab facility that doesn’t have a clue on what to do.

I've been dealing with cervical disc issues since early 2026, severe enough that I've spent 8 months working lying down. My April 2026 MRI shows large left-sided disc extrusions at C5-C6 and C6-C7 causing mild canal stenosis, ventral CSF effacement, direct indentation of the left ventral spinal cord, severe left neural foraminal stenosis, and compression of the exiting C6 and C7 nerve roots — plus a right paracentral protrusion at C7-T1 with minimal cord mass effect. No cord signal abnormality, but the mass effect and cord deformity are described as greatest at C5-C6 and C6-C7. Completed insurance-required PT with worsening symptoms, which cleared the path to a two-level ACDR with a surgeon at Duke Health on August 12.

Duke has only two institutionally approved devices: Mobi-C and Simplify. My surgeon has done high volume on Mobi-C but noted his practice has seen endplate subsidence issues with it, which is why Duke is transitioning toward Simplify. The problem is that transition is in its infancy — Simplify case volume at Duke is low, meaning my surgeon's personal experience with the device is limited. Compounding that, recent MAUDE database analyses (2024-2025) show Simplify now has the highest osteolysis rate among currently FDA-approved cervical disc devices — the only device previously ranked higher, the M6-C, was pulled from the market in February 2025. A 2025 retrieval study separately identified PEEK-ceramic bearing wear and titanium coating delamination as likely mechanisms — a failure mode that bench testing didn't predict and that tends to surface at the 5-7 year mark, exactly where Simplify sits today.

I previously got a second opinion from Virginia Spine Institute with Dr. Jazini and was genuinely impressed with him and his team. I'm now seriously considering switching back to VSI — out of network and significantly more expensive — specifically to access the ProDisc C Vivo. Its titanium coating bonds to a titanium alloy endplate rather than a PEEK substrate, making delamination far less likely than with Simplify. Its fixed-core ball-and-socket design also means articulation happens entirely at the bearing surface rather than at the implant-bone interface, distributing load more evenly across the endplate and avoiding the subsidence pattern seen with Mobi-C's mobile core. It has 225,000+ implants globally with a reported reoperation rate under 1%, and just received two-level FDA approval in October 2025. Has anyone navigated a last-minute surgeon switch specifically over device selection, or have a negative or positive experience with any of these devices?

I really would like to do what I can proactively to avoid a revision due to a device failure if possible.

I underwent the ALTDR surgery on L4-L5 and L5-S1 about a week ago and coming home from the hospital, I noticed that it looks like my penis size has shrunk from what it was before the surgery. I’m still wearing my binder, and I’m not sure if that has just shifted around body fat or something.

I know this is TMI, but is It looks like my penis has shrunk when soft rather significantly. I’m not huge to begin with, but the Mons Pubis (aka fupa) seems larger and my penis itself seems much smaller and may have moved downward a bit from before?

Has anyone experienced anything like this with this type of surgery? I know I’m still very recently out of the surgery, but it has really shocked me. This is embarrassing for a number of reasons, but before I talk to my doctor I want to hear anyone else’s experience with this issue. I still have not achieved an erection due to the nerves and much of the area just not feeling good yet, but I’m concerned that it will be smaller as well.

It sucks to have to bring this up, but please be nice. I’m concerned about this and any other effects it might have on my body. I wish the doctor had mentioned this possibility….

Thanks in advance for our advice and stories.

I (23F) had a L5S1 Laminectomy for a calcified disc bulge that caused cuad equina syndrome in march 2026. I’m in a happy relationship and we’re getting married next year, do I have any hope of starting a family? I’m terrified of hurting my back, or losing the feeling waist down again…I’ve always dreamed of being a mother and this along with a Sjogrens diagnosis makes it feel like it will stay a dream. Of course I will wait more time until I’m more healed and I know you guys aren’t medical professionals, just looking for input and advice.

I have surgery this Monday so I am a little nervous lol.

I had a question, what kind of pain medication did they prescribe? Did they also provide antibiotics for you?

Just curious.