I know that you would like to be able to “control” your destiny by getting a third microdiscectomy and changing your diet and activities to prevent yet another herniation. Unfortunately, the chances of another disc herniation are about 50% regardless of your diet or activity restrictions.
Fusion has a very high chance of working if properly performed. Yes, there is the chance of adjacent segment disease but that chance is small. The chances are much higher of a recurrent disc herniation and/or permanent nerve damage with just another decompression.
If this was my back, I would pick the fusion by a competent and experienced surgeon.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.