[annapurna]

I can't recommend Henry's course of action more: find a surgeon you feel comfortable with before you settle on a course of treatment. There have been people who received ADR but really needed fusions and found their lives post-surgery to be miserable. You seem to have a whole lot going on in your lumbar spine. Much of that might resolve on its own with the weight you've lost but you really need to keep every option on the table until you've found and discussed your situation with at least one, preferably two, surgeons who you feel are trustworthy and competent. Fusion/ADR hybrids are standing up to the test of time so you shouldn't necessarily rule them out until you've had a chance to see if you need the hybrid.