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Severe scoliosis and AP fusion. Facing balance issue after surgery. Degenerative disc disease and osteoarthritis in parts of body. Cure?

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I had severe scoliosis most of my life. I had A/P fusion from T2 to the sacrum done in 2004. I had a balance issue after surgery so a year later an osteotomy was done @ L3. I continued to lean forward and two years later in 2007 another osteotomy was performed @ L2, the fusion extended to S2 and instrumentation to the pelvis was also done. At the time nothing was done to my neck even through I had a curve there as well. My surgeon said my spine was covered in arthritis and I had a lot of DDD. I have osteoarthritis in other parts of my body as well. I just had my left knee replaced due to arthritis under the kneecap and bone on bone in the joint. I would like your opinion of my latest MRI report of my neck that I have pasted below this message. If I do need to have something done, do you think it will involve the rods that are already there? Looking forward to your reply. Thank You, XXXXXXX B.
The cervical spinal cord signal and morphology are normal. There is severe degenerative change involving the articulation between the odontoid and anterior arch of C1. The atlantoaxial facets demonstrate moderate degenerative changes as well. The craniocervical junction is unremarkable.

C2-C3 - There is mild disc desiccation. No disc herniations or spinal stenosis. There is mild facet joint arthropathy.

C3-C4 - There is mild disc desiccation. There is a small disc osteophyte complex without stenosis. There is mild facet arthropathy.

C4-C5 - There is mild disc desiccation and disc height loss. There is a circumferential disc osteophyte complex without stenosis. There is mild facet joint arthropathy.

C5-C6 - There is moderate Modic type I endplate change. There is severe disc desiccation and moderate loss of disc height. There is a circumferential disc osteophyte complex. There is mild central spinal canal stenosis. The thecal sac measures 10-11 mm. There is severe right foraminal stenosis. No left foraminal stenosis. There is minimal facet arthropathy.

C6-C7 - There is mild disc desiccation and minimal loss of disc height. There is a small 2 mm broad-based central disc protrusion. This results in mild central spinal canal narrowing. The thecal sac measures 10 mm. No foraminal stenosis. There is mild facet joint arthropathy.

C7-T1 - There is minimal disc desiccation. No disc herniations or stenosis. The facet joints are normal.

1. Degenerative disc disease and mild scattered facet joint arthropathy involving the cervical spine as detailed above. There is mild central spinal canal stenosis at C5-C6 and C6-C7. There is severe right forminal stenosis at C5-C6. There is Modic type 1 endplate change at C5-C6.
Posted Mon, 28 Oct 2013 in Back Pain
Answered by Dr. Praveen Tayal 3 hours later
Brief Answer:
Surgical treatment is not immediately needed.

Detailed Answer:
Thanks for posting your query.
I have seen the MRI report that you have pasted. The changes in the cervical spine are of moderate intensity and can be managed with the help of medicines and cervical traction. Regular physiotherapy will help in decreasing the further progression of degenerative changes.
Surgical decompression of the disc will be required if there are nerve compression symptoms in the region of C5-C6. This includes neck pain radiating to the arms, tingling and numbness in the fingers, muscle wasting, etc.

The conservative line of treatment will be in form of rest, anti inflammatory medications, nerve tonics, cervical collar and most importantly physiotherapy in form of local ultra sonics/TENS, cervical traction and neck isometric and shoulder strengthening exercises.

This if done properly should help relieve the symptoms soon. If not, surgical intervention will be imperative. Surgery is required if persistent pressure over the nerve root causes loss of function of the muscles it innervates and sensations it gives to a part of skin. Consulting a neurologist will help in deciding the severity of symptoms that you are having. The surgical intervention is not likely to affect the rods that are already there.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
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