Treatment options for spondylolithesis
I have been struggling with back pain for many years now. Sometimes its worse, and sometimes I manage better. I was diagnosed with degenerative disc around L4-l5, and now my orthopaedic Surgeon says I have Spondylolithesis on the same area. I experience a lot of back pain accompanied by leg pain- apparently caused by nerve compression. Conservative treatments don't seem to work well for me anymore. Last year in March I did a Rhizotomy to relive pain, which didn't seem to work for me as the pain just continued after the procedure. This year in June I did a spinal cortisone injection, I was told that might relieve pain for few months. I had a flair up of back pain immediately after the procedure, and the injection didn't seem to help as the pain just continued like it did before. I am in pain most of the time, my work load and travelling makes things worse, I just feel i'm at the end of my tether. I'm a bit sceptical about doing back surgery. Currently I take pain killers, I do Pilate exercises regularly and maintain a reasonable weight. I also use heat pads on my back a lot to relieve pain.
I want to explore the possibility of doing surgery: an artificial disc replacement instead of a spinal fusion, but i'm not sure what is the benefit of one over the other. I want something that will not limit my movements and allow me to have as normal a lifestyle as possible with less or no pain at all! I have read though that some people who have done the fusion will experience stiffness and pain even after the operation, but I have not read much about the artificial disc replacement procedure. Recently my Orthopaedic Surgeon indicated that he might do it for me, the medical aid might approve if he motivates, but I saw a Neurosurgeon recently for a second opinion about the procedure- he was sceptical about the artificial disc, he instead recommends the spinal fusion. Which one is the best for me, I need some advice on the matter, and generally what I can do to manage my pain. Can someone advice?