Question: I had thoracotomy with rib desection to fuse T9 in 1990 for post car accident. I worked as a nurse for 20 years, however severe back pain, increased numbness and tingling of right leg and both feet has halted my carrer as of 3 years ago. my right leg feels weaker and I notice my right knee has recently been going numb. I have buttock pain and shooting paings that travel to calf and bottom of foot. Right side more prominent. I had an abnormal MRI 3years ago and have been treated with meds for neuropathic pain. Recently a new MRI showed increased multifactorial, multi level post operative changes since the last MRI 3 years ago. Recent MRI shows staircasing anteriolisthesis of C2 on C3, C3 on C4, C4 on C5. Also an increase with indentation to C7 which has increased disc protrusion with ventral cord contact. Also noted Spondolesthesis of Lumbar. I believe L4 on L5. Also my first MRI showed cord contact of transverse nerves of Sacral with disc material bilateral. I feel my symptoms have increased. Hard to write type,or grip very long due to hand and finger pain of right hand. My neck range of motion has changed. My neck feels so fatigued. The easiest way to describe..It is like trying to hold a heavy bowling bowl on the top of my head. I have has 1 epidural 4 months ago with minimal relief and a short duration. My next is scheduled in a month. I really am concerned.. Note: During my epidural the doctor was unable to place gauge between C6 because of anteriolisthesis. They placement was done @ C7-T1. I forgot to mention I have moderate cervical facet disease shown on both MRI's of the cervical spine. A bone scan also showed this facet disease. Also disc dessication cervical and thoracic area. Forgot to mention osteophyte @ T9 with annular tear. I awaken at night due to back pain and severe numbness and tingling.

Would this require ortho spine surgeon or neuro surgeon and can upper and lower be done during same surgery?