[annapurna]

I'm going to dodge the question of who to talk with to get your surgery but, instead, think more about what you need to do. I'd be more critical of getting an ADR at L5S1 if your facets are already as badly compromised as you indicate. The whole marketing literature about how good modern ADRs are aside, there's a reality that it's impossible for them to have completely perfect physiologically appropriate movement and the facets can often take abuse at ADR levels. Sometimes the facets improve because using and ADR to raise the disk spacing to the correct height improves the loading on the facets. Other times, the facets are simply too bad and the improvements possible with the ADR aren't enough to help. I'd ask a lot more about that if you were more serious about the dual ADR approach.