If you're asking 'what would you do', I'd fuse S1/L5 and ADR L4/5. L4/5 is already compromised. The disco will further degenerate the disc which will most probably further degerenate in a very short period of time, leading to more pain and as follows, more surgery, this time with extra scar tissue.
Could the fusion and discectomy lead to several years of relief - yes. Is this probable, IMHO and based on personal experience and other posts, no.
This is your back and your decision. S1/L5 doesn't move much so fusing that space probably won't interfere with activities. But L4/5 is already bad and the chances of further degeneration, especially with the fusion below are pretty good.
BTW, if doctors don't perform ADR surgery, they're not likely to recommend it. The more honest opinions come from doctors who do it all. They won't be losing work by recommending anything and have no personal motives.
Please do your research. Minimal surgery at L4/5 will let you do it again, but just how much relief will you get and how long will it last?
Good luck, Dale
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3 level Prodisc adr S1-L3, Oct 12, 2005
Dr. B in Bogen, Germany
Severe nerve damage in left leg, still working on it
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