Remember... I'm a layperson, not a doctor, so don't take anything I say as anything other than the opinion of a layperson.
Was discography done? How did they decide to rule out L5-S1? If there is some reason to believe that most of your pain comes from L4-5 and the L5-S1 is NOT a significant pain generator, then proceeding as planned may make some sense. (IMHO)
However, if this is based on wishful thinking and on the idea that XLIF is so minimally invasive that it’s like a ‘freebie’, then this is another story.
Remember the vaudeville joke….
“what are you looking for?”
“my keys”
“where did you lose them?”
“over there”
“why are you looking over here?”
“Because the light is better over here.”
If they are doing XLIF because the light is better there, then???
Less surgery is better than more surgery. Less invasive surgeries are only better than more invasive surgeries if the compromises of less invasive surgeries are worth the trade-offs, and there are significant trade-offs. MISS is not always better. One surgery is better than two. (Unless of course you are the one being paid for two surgeries instead of one.)
All the best.
Mark
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