I just wanna say Nuerontin never did anything for me.And celexa either . You may want to get them to change your meds to stronger . I have never tried the duragesic patch. I was told by my PM doc that they may not be able to cover all my pain completely. I came down to a 0 and then the highest it would go up is like 5. But then lately I don't know if it has to do with the weather I have been going up to 10 again.I had to increase all meds. I take Effexor XR with darvocet and Mepergan for the highs. I'm sorry no one had answered your email sometimes we get busy with family . Well hope this helps. As for the surgery I wouldn't rush into that.Make sure you find one of the best surgeons in the US or go to Germany. Lillian