Wow.
I'm glad that you are moving forward towards a solution, but so sorry that you must consider another surgery.
Does another anterior surgery limit your future options if you need further spine surgery?
Do the posterior elements behind L4/5 look good?
Is he sure that the 4-5 level is not a continuing pain generator? Have you discussed the possibility of 2-level posterior fusion if pain from continued motion at 4-5 is not ruled out?
If anterior is better, has he discussed anterior only with newer cages that include screw fixation instead of needing posterior support?
I have a bunch more questions that are probably best discussed off line... call me.
Mark
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