[FranklySir]

ED,

Second both Anna and Henry with caveats.
You say you lost 200+ lbs but not what kind of shape you are in as meaning strong and kinda in shape or in great shape muscle wise.
My suggestion to you would be to go conservative along with getting informed and comfortable with the surgeon that you would go with if you need to.
In the mean time get in the best shape of your life as best you can given your condition before thinking about surgery. As anna points out "Much of that might resolve on its own with the weight you've lost". Not saying you won't need to do something but without knowing how your core strength is jumping in and getting cut might not be the best option and really won't do a damn thing IMHO if you don't give yourself the best chance in getting strong first. You might be worse off unfortunately. I'm no trying to scare you any more but rather prepare you. It's not an easy thing and you will need all the strength you can muster to be successful.

Fusion at L5S1 is not a bad thing as Henry points out and most recently Drew. For myself I opted to leave L5S1 alone since it was not giving pain and almost fused on its own anyway after 20 years of injections and physical workout along the way.

My advise is to give it time, do your homework, get in shape other than weight loss and you might find things settle down. None of it is easy. Catch 22** back hurts/ hard to workout right? Hard pill to swallow since we all want it to go away quick but as I'm sure you found losing 200+ wasn't easy either. Congrats on that since that takes a lot of will power as well!!

Be well.

Frank