I don't know why anyone would suggest that ADR or fusion is the only option for large, central herniations??? If your disc is so severely degenerated that a discectomy is not likely to succeed, that may be closer to the truth.
Time heals many spine problems. After a year, if it's going in the right direction, I'd wait. However, if your life is bad enough to consider surgery and it's not getting better, I'd look long and hard at your options.
I don't think they are 'smoke and mirrors'. In some cases it seems that they are willing to perform surgery on a poor candidate because they believe that they will not make them worse. That does not mean that on prime candidates, their surgery is not likely to be a success.
Mark
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