28 August 2025

The Ultimate Checklist: How to Choose the Right Surgeon for Artificial Disc Replacement (ADR)

When you need artificial disc replacement (ADR) surgery, choosing the right surgeon is very important. Unlike many medical procedures, artificial disc replacement is a highly specialized surgery that demands exceptional skill, extensive experience, and deep understanding of spinal biomechanics (how the spine moves and functions). The artificial disc must be positioned with millimeter precision to restore natural movement patterns, and even small variations in surgical technique can mean the difference between years of pain relief and continued suffering. Studies consistently show that surgeons who perform higher volumes of ADR procedures achieve better patient outcomes, fewer complications, and longer-lasting results.

This comprehensive checklist will guide you through the essential factors to evaluate when selecting your ADR surgeon. Whether you’re just beginning to research artificial disc replacement or ready to schedule consultations, these evidence-based criteria will help you identify the surgeon who’s truly qualified to perform this life-changing procedure and partner with you throughout your recovery.

Why Your Choice of Surgeon is Crucial for ADR Success

Artificial disc replacement is one of the most technically demanding procedures in spine surgery, requiring specialized training that goes far beyond general orthopedic or neurosurgical education. The surgeon must have a deep understanding of spinal biomechanics (how the spine moves and functions naturally) to properly position the artificial disc device. Unlike spinal fusion where small positioning variations may be less critical, ADR demands precision because the artificial disc must replicate the complex motion patterns of your natural disc while maintaining proper alignment with surrounding vertebrae and joints. Even small differences in placement can affect how forces distribute through your spine, potentially leading to device wear, adjacent segment problems, or continued pain.

Higher-volume spine surgeons consistently achieve lower complication rates, with studies demonstrating reduced postoperative morbidity and shorter hospital stays compared to lower-volume practitioners.¹ For ADR specifically, experienced surgeons are better at selecting appropriate candidates, choosing the right device for each patient’s anatomy, and performing the precise surgical techniques needed to ensure the artificial disc functions properly for decades. The right surgeon doesn’t just perform the operation—they partner with you throughout the entire process, from careful pre-surgical planning to comprehensive post-operative care that maximizes your chances of returning to an active, pain-free lifestyle.

Your ADR Surgeon Evaluation Checklist

Board Certification and Fellowship Training

Before you put your spine in anyone’s hands, make sure the surgeon has the right credentials. Board certification means the doctor has completed a full residency (multi-year hospital training) and passed tough written and oral exams in either orthopedic surgery or neurosurgery. A one-year spine fellowship—an extra, highly focused apprenticeship—goes even further by giving the surgeon daily, hands-on experience with complex spine cases like artificial disc replacement. Fellowship-trained surgeons spend that year mastering spinal anatomy, precise implant placement, and motion-preserving techniques, skills that are critical when every millimeter counts.

Credentials alone don’t guarantee great results, but they do set a minimum standard you can verify. Always ask for proof, double-check certification on the American Board of Medical Specialties website, and be wary of vague answers. A surgeon who freely discusses their training, mentors, and ongoing education is more likely to stay current with the latest devices and best practices.

Questions to consider:

Are you board-certified in orthopedic surgery or neurosurgery, and when was your last recertification? (Look for current certification; most boards require recertification every 10 years)
Did you complete a dedicated spine fellowship? (Fellowship training is essential for complex procedures like ADR; prestigious programs often indicate higher quality training)
How many artificial disc replacements did you perform during fellowship and in total since then? (Fellowship should include ADR exposure; total career numbers should be in the hundreds for experienced surgeons)
What percentage of your current practice is devoted to spine surgery and, specifically, motion-preserving procedures like artificial disc replacement? (Look for 80-100% spine focus, with significant portion dedicated to motion-preserving techniques rather than just fusion)
Can I verify your certification through the American Board of Medical Specialties or a similar body? (Legitimate surgeons will provide this information freely; you can verify online at abms.org)

Experience and Case Volume

Experience matters more in artificial disc replacement than almost any other spine procedure. Unlike routine surgeries where basic competency may be sufficient, ADR requires a surgeon who has performed the procedure hundreds of times to master the precise positioning, patient selection, and problem-solving skills needed for optimal outcomes. The learning curve for artificial disc replacement is steep, and studies show that surgeons with higher case volumes consistently achieve better results, fewer complications, and longer-lasting implant performance.

Questions to consider:

How many total artificial disc replacement surgeries have you performed? (Look for at least 50 cases, with top surgeons having performed 100+ procedures)
How many ADR surgeries do you perform each month or year currently? (Regular, ongoing practice is crucial for maintaining skills)
How many years have you been performing artificial disc replacement procedures? (Ideally 5+ years of experience with the technology)
Do you perform both cervical (neck) and lumbar (lower back) artificial disc replacement? (Dual expertise shows comprehensive understanding of spinal biomechanics)
Can you show me data on your complication rates and patient satisfaction scores for ADR procedures? (This should be “Yes”)
Have you been involved in clinical trials or research studies for artificial disc replacement? (This indicates cutting-edge expertise and commitment to advancing the field)

Focus on Motion Preservation

A top artificial disc replacement surgeon should be fundamentally committed to preserving your spine’s natural movement whenever possible. Motion preservation is what separates ADR from traditional spinal fusion—it’s the core philosophy that drives everything from patient selection to surgical technique. The best ADR surgeons view motion preservation not just as a benefit, but as the primary goal of treatment. They understand that maintaining spinal flexibility reduces stress on adjacent segments (the discs above and below the treated area), potentially preventing future problems and preserving your quality of life.

Questions to consider:

Does motion preservation form the core of your surgical philosophy? (Look for surgeons who prioritize maintaining natural spinal movement and view fusion as a last resort)
What percentage of your spine surgeries are motion-preserving procedures versus fusions? (Higher percentages of ADR and other motion-preserving techniques indicate specialization in this approach)
How do you decide between artificial disc replacement and spinal fusion for a patient? (Top surgeons should have clear, evidence-based criteria favoring motion preservation when appropriate)
Can you explain the long-term benefits of preserving motion in my specific case? (They should discuss reduced risk of adjacent segment disease and maintained flexibility)
What other motion-preserving techniques do you offer besides artificial disc replacement? (Experience with multiple motion-preserving options shows comprehensive expertise in this philosophy)
How do you counsel patients about the trade-offs between ADR and fusion? (They should emphasize motion preservation benefits while being honest about appropriate candidacy requirements)
Do you have outcome data showing the success of your motion-preserving procedures? (Ask for specific results regarding pain relief, mobility preservation, and patient satisfaction with ADR procedures)

Technology and Techniques

The technology and surgical techniques your surgeon uses can dramatically impact your recovery time, pain levels, and overall success with artificial disc replacement. Minimally invasive approaches use smaller incisions, specialized instruments, and advanced imaging guidance to reduce tissue damage during surgery, which typically means less post-operative pain, shorter hospital stays, and faster healing. Additionally, experienced ADR surgeons should have expertise with multiple artificial disc brands and designs, allowing them to select the specific implant that best matches your anatomy, activity level, and spinal condition rather than using a one-size-fits-all approach.

Questions to consider:

Do you perform artificial disc replacement using minimally invasive techniques? (Look for surgeons who use smaller incisions, tubular retractors, and muscle-sparing approaches rather than traditional open surgery while understanding that open surgery may be unavoidable in some cases)
What specific minimally invasive instruments and technologies do you use for ADR procedures? (Advanced surgeons should mention image guidance systems, specialized retractors, or navigation technology)
Which artificial disc brands and models do you have experience implanting? (Experienced surgeons should work with multiple FDA-approved devices like ProDisc, Prestige, Mobi-C, or M6 discs to match your specific needs)
How do you decide which artificial disc design is best for my particular case? (They should consider factors like your anatomy, activity level, bone quality, and specific spinal condition)
Can you show me the difference between the artificial disc options you offer? (Top surgeons should explain how different designs move, what materials they’re made from, and why one might be better for your situation)
Do you use computer navigation or robotic assistance during ADR surgery? (Advanced technology can improve precision and outcomes, though not all excellent surgeons use these tools)
What is your typical incision size for artificial disc replacement? (Minimally invasive approaches typically use incisions of 2-4 inches rather than the 6+ inch incisions of traditional open surgery)

Patient Outcomes and Reviews

Real patient experiences and outcomes provide the most honest insight into what you can expect from your artificial disc replacement surgery. While credentials and technical skills are important, hearing from people who have actually undergone ADR with your surgeon gives you a clearer picture of their bedside manner, surgical results, and long-term patient satisfaction. The best ADR surgeons are proud of their outcomes and willing to connect you with former patients, while also maintaining strong online reputations that reflect consistent, high-quality care over many years.

Questions to consider:

What are your typical patient satisfaction scores for artificial disc replacement procedures? (Ask for specific percentages or survey results, not just general statements about “happy patients”)
Can you show me before-and-after imaging studies from successful ADR cases similar to mine? (Visual evidence of proper implant positioning and maintained motion can be very reassuring)
What do your online reviews say, and how do you respond to negative feedback? (Check Google, Healthgrades, Vitals, and other review sites; good surgeons address concerns professionally)
How do you track and measure long-term outcomes for your ADR patients? (Top surgeons follow patients for years and can provide data on pain relief, functional improvement, and implant durability)
What is your revision rate for artificial disc replacement surgeries? (Ask what percentage of ADR patients need additional surgery; lower revision rates indicate better initial outcomes and patient selection)

Consultation and Communication

Your consultation is often the best indicator of how your surgeon will treat you throughout your entire artificial disc replacement journey. Great ADR surgeons understand that informed patients make better decisions and have better outcomes, so they invest time in thorough explanations, encourage questions, and create an environment where you feel heard and respected. The way a surgeon communicates during your consultation—their patience, clarity, and willingness to discuss both benefits and risks—often reflects the quality of care you’ll receive before, during, and after surgery.

Do you feel rushed during the consultation, or does the surgeon give you adequate time to discuss your concerns? (Quality surgeons typically spend ~30 minutes in initial consultations and don’t make you feel hurried)
Does the surgeon explain the artificial disc replacement procedure in terms you can understand, avoiding excessive medical jargon? (They should use clear language and visual aids like models or diagrams to help you understand the surgery)
Are they willing to discuss both the benefits AND the potential risks or complications of ADR surgery? (Honest surgeons will explain success rates, possible complications, and what could go wrong, not just the positive outcomes)
Do they encourage you to ask questions and take time to answer them thoroughly? (Red flag if they seem impatient with questions or give rushed, incomplete answers)
Do they explain why you’re a good candidate for artificial disc replacement versus other treatments like fusion? (They should provide specific reasons based on your imaging studies, symptoms, and medical history)
Do they discuss what your recovery will realistically look like, including timeline and expectations? (Avoid surgeons who promise unrealistic outcomes or downplay the recovery process)
Do you feel comfortable enough with this person to trust them with a major surgery on your spine? (Your gut feeling about the surgeon’s competence, honesty, and bedside manner is important and shouldn’t be ignored)

Why Dr. John H. Peloza Easily Checks All the Boxes

When evaluating an artificial disc replacement (ADR) surgeon using our checklist, Dr. John H. Peloza clearly meets or exceeds the essential qualifications:

Spine Surgery Fellowship Training

Dr. Peloza is a board-certified orthopedic surgeon who has completed several fellowships in spine surgery.

Dallas Spine Group (Dr. David Selby)

This fellowship was performed at the Dallas Spine Group in Dallas, Texas, under the mentorship of Dr. David Selby, one of the founders of the North American Spine Society (NASS). The focus was on advanced techniques in spine surgery, including spinal fusion and early innovations in minimally invasive surgeries. Dr. Selby’s mentorship gave Dr. Peloza strong grounding in both the science and art of complex spine reconstruction and disc surgery.

Minneapolis: Institute for Low Back Care & Others (Drs. Ray and Burton)

As part of an organized traveling fellowship, Dr. Peloza trained in Minneapolis with Dr. Charles Ray and Dr. Charles Burton, both pioneering figures in neurosurgery and spine care and also founders of NASS. Their expertise lay in the development of new spinal implants (like cages and artificial discs) and surgical techniques for degenerative disc disease and complex spinal conditions. This exposure gave Dr. Peloza advanced skills in both device-based and biologic reconstruction of the spine.

Royal Hammersmith and Cromwell Hospitals, London UK (Sir Harry Crock)

Dr. Peloza spent significant time as a fellow under Sir Harry Crock at the Royal Hammersmith and Cromwell Hospitals in London, United Kingdom. Sir Harry Crock’s expertise was in complex spinal surgery and spinal trauma, and during this fellowship Dr. Peloza learned about international approaches to spine surgery as well as the nuances of treating severe spinal injuries and deformities.

Spinecare (Dr. Art White)

Dr. Art White is noted for innovations in patient-centered spine care and nonoperative back treatment, which informed Dr. Peloza’s holistic understanding of spine health.

Each location provided Dr. Peloza the opportunity to closely learn from world-renowned mentors and gain expertise in both operative and nonoperative spine care, as well as exposure to pioneering technology and minimally invasive techniques. This training, combined with decades of ongoing peer-reviewed publication and presentations at national and international meetings, underscores his foundation in both surgical skill and academic excellence.

Experience & Case Volume

Since the FDA-approved trials for ADR, he has performed both cervical and lumbar artificial disc replacements and even served as a principal investigator in those early IDE studies. His career spans more than 30 years, and his practice is consistently ranked among the top 50 spine surgeons nationally, indicating substantial case volume.

Motion-Preservation Philosophy

Dr. Peloza is described as a pioneer in motion-preserving techniques, viewing artificial disc replacement as the first-line option whenever appropriate—and using fusion only when necessary. His practice philosophy is deeply rooted in preserving spinal mobility.

Technology & Surgical Approach

He is an early adopter of minimally invasive spine surgery, robotics, image-guided navigation, and even augmented reality (AR) operative systems, along with traditional disc systems in both cervical and lumbar positions. He offers a range of FDA-approved artificial disc models and tailors device selection to each patient’s unique anatomy and condition.

Patient Outcomes & Testimonials

Scores of patient testimonials describe life-changing results, restored mobility, and high satisfaction with bedside manner and communication. He has also authored peer-reviewed journal articles and book chapters and speaks frequently about innovations in spine surgery—strong indirect evidence of an outcomes-tracking mindset.

Consultation Style

From patient feedback and practice descriptions, Dr. Peloza offers unhurried, informative consultations, using educational spine models, radiographic images, and implant examples to illustrate your diagnosis and treatment options. Patients report that he welcomes and thoroughly answers questions.

Take the Next Step with Confidence

Choosing the right surgeon for artificial disc replacement is one of the most important healthcare decisions you’ll ever make. The comprehensive checklist we’ve outlined gives you the tools to evaluate potential surgeons systematically rather than leaving such a critical choice to chance. By asking the right questions and knowing what answers to look for, you can identify a surgeon who not only has the technical expertise to perform your ADR procedure safely but also shares your commitment to preserving spinal motion and achieving the best possible long-term results.

If you’re considering artificial disc replacement, Dr. John Peloza brings the rare combination of pioneering experience and patient-centered care that defines exceptional ADR surgery. As one of the original investigators of artificial disc replacement technology in the late 1990s, Dr. Peloza has been perfecting these procedures for over two decades and has helped hundreds of patients return to active, pain-free lives. His commitment to motion preservation, minimally invasive techniques, and personalized treatment plans makes him uniquely qualified to evaluate whether ADR is right for your specific condition and goals.

Ready to learn more? Schedule a consultation with Dr. Peloza to discuss your artificial disc replacement options.

During your consultation, bring this checklist with you and don’t hesitate to ask Dr. Peloza any questions about his experience, approach, or your specific case. The right surgeon will welcome your thorough evaluation; it shows you are a thoughtful patient who’s committed to achieving the best possible outcome from your artificial disc replacement surgery.