I would ask... with the coflex-f in situ for 3 years, plus the severe degeneration for so long before, what are the odds of auto-fusion.
You may be able to get insurance to pay for a 2 or 3 level fusion, then cap it off with ADR or other motion preservation? Minimally invasive fusions may be possible with XLIF or ALPA approach (but not likely at L5-S1).
With all the "I'm not a doctor" qualifiers... just asking questions!
Mark
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