I also had severe pn and a pinched nerve in my l4,5 area. Eventually I decided on surgery. I've been dealing with this for years. Along with the pn I was truely suffering. Surgeons wanted to fuse and stabalize the area. All too many surgeons look upon this as the way to take care of the problem. I kept looking and eventually found Dr. Gordowski at Vanderbilt. He is a specialist in deteriorating backs and conducts micro surgery. This can be a dangerous procedure but if it doesn't work, then fusion can later be done. I opted for this. The problem with fusions is that they tend to fail within a 7-10 year window. And then you need more fusions. My pinched nerve and the area surrounding it have been freed and that problem is resolved. I must continually do strengthening exercises for the rest of my life to try and keep this area problem free. Unfortunately, there was too much long term damage to my lower area and I continue to have pn. At least I can move my left foot which I couldn't do very well before surgery. Look around and check with surgeons who just do fusions. Afterall, surgeons make money by performing what they can do. I don't know if this info is of assistance, but check with specialists who give you more than one option. My 2 cents.