@sassytwo While I admire your determination to continue in your lifestyle and activities, your MRI report seems to be an indicator on what is to come in your future if you avoid surgery. It is telling you how fast things have changed since the last 8 years. Levo roto scoliosis means that your spine is twisting to the left and rotating centered at L2, and this has increased by 12 degrees in the last 8 years to 30 degrees. Looking forward, if this trend continues, the question is how much more will the spine rotate and what internal organs will be affected? Will this contribute to disability? Will it compromise lung function? Are there any other scoliosis curves developing in the thoracic spine to compensate for what is going in the lumbar spine? If the lungs don't move properly, it can trap phlegm and lead to repeated lung infections or pneumonia, and these are concerns that can represent a serious risk in an aging adult. I have had a bit of a problem with proper chest wall movement because I have thoracic outlet syndrome that was restricting one side of my ribcage. I have been working with a physical therapist who is doing myofascial release and getting the muscles around my chest wall to soften and allow my lungs to move better. Over time, we all develop patterns of body tightness. I also have asthma which complicates things, so I worry about lung function and the risks of any type of respiratory infection. I imagine with scoliosis , that can create some unusual tightness patterns.

Have you worked with a physical therapist to try to improve some of the effects of the scoliosis?

From your MRI report, since 2015 after the microdiscectomy, this level has grown bone spurs forming a ridge that is causing stenosis at the nerve roots on the right side. and you also have left nerve root stenosis at L4/5 and L5/S1. The stenosis in the central canal at L3/L4 is also a concern for spinal cord compression and the note says it has progressed.

I presume this progression is in relationship to 2015 when you had the microdiscetomy.

I can imagine how the activities of riding bikes, working as a massage therapist and having to lean over, and twisting to play golf would be activities that would be hard on you physically in this condition. With the spine as a shock absorber to the body, any activity that has a pounding impact like running, hitting bumps on a bike, etc, would be hard on the spine. If you have a multilevel lumbar fusion, I suspect that your doctors would likely advise you not to continue doing activities that jar the spine because it would transfer the forces to the levels above the fused levels. I am a spine surgery patient with a cervical fusion, and I don't want to do anything to jar my spine. I do have a horse that I ride, but he doesn't trot because he is gaited, so that is just a smooth fast walk, and that is all I really do, just walk which is good exercise for core strength to support my spine.

I know this is a hard choice, and getting several different surgical options would be a good idea since this is a very complex problem. A spine deformity expert with experience with scoliosis experience is a good choice for a consult. My spine surgeon, Jeremy Fogelson, at Mayo is a spine deformity expert. There are artificial discs for lumbar spine, but they may be limited to single level replacements. You'll have to ask your surgeons if any are approved for multilevel problems or for a level next to a fusion or scoliosis involvement. This may be why surgeons are recommending a fusion of the entire lumbar area. The scoliosis complicates things too, and perhaps that may indicate a fusion. Surgeons cannot promise to cure pain or that you will be pain free after surgery. Scar tissue can cause pain and lead to body tightness. This can be addressed by myofascial release therapy. One question that comes to my mind is about your prior scar tissue from the microdiscetomy... could that be causing tightness that increases pressure on the spine and influences the scoliosis rotation? It may be worth it to consider if myofascial release could help you. It won't cure the damage that is already there, but it can reduce the extra forces of pressure from tight fascia that are pulling on your body.

Ask the surgeons the difficult questions about what your future abilities may be with their recommended surgery and what would like happen without it. There is a lot to consider. Get as many opinions as you need because you cannot undo a surgery once it is done. Choose your surgeon carefully. Find the very best that you can. They are not all equally skilled and it matters in the outcome from surgery.

Your thoughts?

Jennifer