[annapurna]

Two comments: First, I don't know what your flare-up to no pain cycle time is like. If you're having random, unprovoked or flare-up from things related to your everyday life, my suggestion is to continue working on what you'll need to do to make your decision about surgery. The next flare-up will be easier to tolerate and life will be easier to live if you know that you know what you're going to do surgically when you make the decision to do it. At the least, I'd suggest continue working on finding a surgeon you like and understanding how you see the risk/rewards stacking up for ADR vs. ACDF.

The story I remember is when Laura decided to get her L5S1 Charite. We'd spent months working through what surgery to get and who to pursue for the surgeon. Laur was in pain but functional. After we made the decisions, she was still functional. One day mid-Summer, she drove up at home after work and needed assistance getting out of the car and up the three steps into the house because the pain had flared. Because we had pursued a European surgeon, we woke up at midnight (8am in Germany) and had a surgery date and plane tickets by 2am. Laura slept a lot easier through that flare-up knowing that she simply had to deal with pain for a few weeks until the surgery.

Second thought: My opinion, which needs to be tempered with the knowledge that I'm an engineer not a medical professional, is that the gamble is a little different than you depicted. Typically, if you get off the surgery table after your ADR surgery and know that the ADR was well placed and do well within the first year, most people have no long-term problems with the ADR. Charite's are over 30 years old and there's still no major news items out there for the first Charite's failing and being replaced (Rich aka Harrison, Laura and Sir Alastair all have Charites so there's reason for the senior members of this board to look for posts like that). With fusions, it seems to go the opposite direction; you can have a good fusion for the first decade then start having problems from what it had been doing to the mechanics of your spine.