@dacraig The malacia is where your fused levels are. Do you think it is an old injury that was caused by the fall? Do you have old MRI images to compare to back 19 years to see if it was present? Is there any compression happening at the end of the fused levels now? Are you considering a different surgical opinion at another facility? Often, doctors at the same place don't want to counter an opinion of their colleague. Perhaps your neurologists could make a recommendation to another surgeon.