Skip to main content
Spine SurgerySecond Opinion Guide

Should you get a second opinion for lumbar disc replacement?

Lumbar disc replacement is an alternative to spinal fusion for a specific subset of patients with disc-related low back pain. It is approved for single-level disease in patients without significant facet joint arthritis. A second opinion is warranted to confirm you are a suitable candidate and that the diagnosis is clearly disc-related rather than from other spinal structures.

Red flags - consider a second opinion if you notice these

  • You have not had an MRI within the past year confirming disc disease as the primary problem
  • Facet joint disease was not assessed as a contributing factor
  • A discogram or diagnostic injection was not used to confirm the painful level
  • You have multi-level disc disease and disc replacement at all levels is being proposed
  • Non-surgical treatment including supervised physical therapy was not completed

Questions to ask the second surgeon

  1. 1How do you know the disc is the primary pain generator and not the facet joints?
  2. 2Am I a candidate for disc replacement rather than fusion, and what are the advantages for my case?
  3. 3How many lumbar disc replacements do you perform per year?
  4. 4What happens if the disc replacement fails - can it be converted to a fusion?
  5. 5What are the specific risks at my level given my anatomy?
  6. 6What is the expected recovery and return to activity timeline?

What to expect from a second opinion visit

Lumbar disc replacement is performed by a limited number of highly specialized spine surgeons. For this procedure specifically, seeking a second opinion at a major academic spine center is advisable. Bring your lumbar MRI and any results from diagnostic injections.

Common questions

Who is a good candidate for lumbar disc replacement?
Ideal candidates are typically under 60 with single-level disc degeneration, minimal or no facet arthritis, no spinal instability, and pain primarily from the disc confirmed by imaging and diagnostic injection. Patients with multi-level disease, significant facet arthritis, or prior back surgery are generally better candidates for fusion.
Does lumbar disc replacement prevent adjacent segment disease?
That is the theoretical advantage - preserving motion at the replaced level should reduce stress on adjacent discs compared to fusion. Clinical studies show modestly lower rates of adjacent segment disease with disc replacement, but long-term data beyond 10-15 years is still accumulating.

Find a Spine Surgery specialist for a second opinion

Search board-certified surgeons by specialty, location, and accepted insurance - free for patients.

Find a specialist About Lumbar Disc Replacement
All second opinion guides