[annapurna]

Just some thoughts to think about: First, MRIs are almost always done on your back with the spine unloaded. You might see if someone has a backpack style harness that can load your spine and see if the buldge gets much more pronounced under load. My wife's disk buldge wasn't anywhere near enough on the MRIs to cause her the numbness and pain she experienced but as soon as the disk was removed and ADR put in the numbness faded.

Second, though they can really mess up you permanently, you might need a myleogram to sort out how much impingement in your spine you really have. Try to avoid this as much as possible as the test has the potential for permanent scarring and lots of permanent pain if done wrong and can be massively unpleasant for a week or more even if done right.

Third, you should get someone to examine your MRIs or get MRIs if you don't have them to check for the condition of your facets at the affected level. You may be forced into fusion due to structural damage to your facets from the DDD transferring load from the degenerated disk to your facets.

Fourth, as you probably know from your schooling, if you do have Cauda Equina Syndrome you need to move out agressively to bring yourself to a point where you've identified an approach you're happy with and whatever doctors needed to pursue that approach. No one here is smart enough to tell you that you need surgery, but it if you're on the edge of Cauda Equina then you need to be able to react quickly if it gets worse.

All of that said, you asked for an opinion on fusion vs ADR. At your age, you do risk driving degeneration into adjacent levels if you fuse, especially as you have two non-adjacent levels affected now. You might try a combination of fusion and ADR, which has worked for some. You might find your facets or bone density or some other factor eliminate ADR for you, but by and large most of the people on this board like the fact that ADR preserves spinal motion, which has at least the theory of preventing future damage.