Fusion vs MicroDiscectomy with normal disc height

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If posterior annulus is so severely compromised, it may make sense to jump to the more invasive surgery rather than to first try something that stands little chance of success (because the disc is so severely compromised.) However, saying 'good disc height' seems to imply that the disc is not too severely degenerated.

With the average local surgeon, the only treatment options will be 1. nothing (conservative treatment), 2 discectomy, 3 fusion. There are other treatment options available that the average surgeon might not consider. Annular repair devices, posterior stabilization, various types of thermal annuloplasty (with discectomy) hold some promise, but its hard to know where to turn.

The problem with this decision making process is understanding how much to fear fusion. Obviously, there is huge motivation to develop alternatives to fusion, but one spine surgeon will be so very casual about lumbar fusions, while another will be adamant about not doing fusions for pain.

Tough choices.

Mark