Brief Answer:
The features you are experiencing point to myelopathic features.

Detailed Answer:
Hi,

Sorry that you have been experiencing the pain on such a severe scale. I will try to analyze your complaints but I need a few answers from you.

Do you feel any stiffness in your hands and legs and find difficult to move around. Did anyone tell you that your gait has changed recently?
Can you perform fine movements with your fingers like writing, buttoning, feeding yourself with fork or spoon?
Any recent history of trauma?
Any problem peeing and stooling?

I think the lower back fusion was for lumbar spondylolisthesis and not for spondylosis, though it too must have been a co-incidental finding. However it too contributes to the pain. I will need more views of the xrays and also if possible, upload any recent xray of the lumbar spine (lower back) which are taken in the front view and side view. The one you have uploaded are most probably the post-operative xrays done to confirm the position of instruments. New ones need to be done as it will show the exact position and if there was any realignment of the rods and screws. Generally as we age the bone softens up and this in turn causes the rigid screws and rods to change position. This can then pinch the nerves providing your legs and in the long run it causes muscle wastage too. About your leg pointing upward, it could be due to stiffness and the nerves getting weaker. You will really need a thorough neurological check as your symptoms seem to be exhibiting myelopathic features.

Regarding the numbness in the elbows and wrists, it is possible that it could be from cervical involvement where the disc pinches the nerve or it could be from Vit B12 deficiencies. I would suggest you to get a couple of cervical xrays from back view and side view for starters, and if possible B12 levels. Do you have neck pain too?

As for the numbness and pain, I think you will need a prescription drug called pregabalin. It helps in protecting the damaged nerves and decreases the numbness and pain. I think you should also check your Calcium levels and get started on Calcium and Vit D3. Since you say your pain is so very severe now, you would have to see a physician and get a prescription for Tramadol. I would urge you not to go towards opioids now itself.

Also some precautions that I always advise my patients is not to carry heavy weights, bend forward, or overexert oneself during defecation.
Hope I have answered your query. If you have any more doubts please do get back here and I will answer them.

Regards,
Pradeep

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