Hello I'm 54 year old with left sciatica. My medical history is charged with 2 medications for arterial hypertension, 30u lantus daily plus glucophage for diabetes and flecainide for intermittent atrial fibrillation. I had an angioplasty with stent about five years ago. However I did undergo 3 surgeries recently without systemic complications. About two years ago I developed left sciatica. These symptoms were virtually only when I am Standing and used to occur about five minutes of upright posture. If I walkI "loose" my left leg after I walk for about 5 minutes. The pain radiates from the left buttock to the posterior thigh , posterior calf and lateral aspect of the foot. It is not relieved by pregabalin 300 mg daily plus paracetamol and tramadol. Anti inflammatory medications have been tried in the past but had not been helpful. Several epidural shots were tried in the past 2 years with partial relief and for short periods of time. Five months ago, I underwent in Lebanon laparoscopic discectomy which did not relieve my symptoms. My back movement was good. Straight leg raising was painful at 80 degrees on the left. I can stand on my toes and heels without any weakness. A standing MRI of the lumbar spine done in Paris last July showed what appears to be a persistent disc fragment under the left S1 root with no difference between the supine and standing positions. I underwent therefore on July 20 2012 an exploration of the left S1 root by a Dr., a consultant neurosurgeon in London. It had not been exposed during the last surgery and was found to be inflamed and deformed by herniated but adherent disc material. The following morning I was able to walk without sciatica. However the pain returned on the evening of July 21 and was severe on the morning of July 22. Repeat MRI was inconclusive. However I was taken to surgery because the pain was severe, compression of the nerve was strongly suspected, and delayed operation after scarring was thought to be difficult. At surgery on July 22 a free fragment of disc was immediately encountered under the left S1 root. Following this second surgery I was discharged from the hospital in London on July 23. My pain pattern changed after this surgery and I started experiencing pain only in the antero lateral region of the left leg and also in the foot. The pain in the thigh was releived for 2 to 3 weeks. I continued having pain after 5 minutes standing or walking, but I was able to swim uneventfully for 90 minutes daily. I did not have any sciatica in the supine position for the following 8 weeks. 1 week ago he started experiencing pain in the dorsal decubitus postion essentially in the left buttock region and also in the left thigh leg and foot. My pain is now rated 10/10 after 1 minute standing or walking, but his physical exam does not show any motor deficiency so far. I am currently taking the following medicines : Neurontin 400 qid, Cymbalta 60 mg qd , Zaldiar 2 pills qid. The doctors think that I have now fibrosis around the nerves and that an arthrodesis is mandatory, but the question is whether to do it now or to wait?