Dear Dr. Corenman
I would like to thank you for your time in reading and replying to my previous message.
In the last couple of months, I have been referred to another specialist and had a new CT scan.
The standing segmental kyphosis is about 32 degrees. Is that the same thing as cobb angle? Apparently I am not particularly out of balance sagitally but I do notice the more rounded shape of my mid-back. I find I get progressively fatigued during the day and frequently have to lie down.
The T12 is crushed into a trapezoid. The crush and kyphosis is more marked on the right versus the left. There is also marked degenerative change at L2/3 but also L1/2 and L3/4. Given the more widespread change, the specialist would prefer to avoid surgery since it should also include those levels and would be extensive.
I am curious what type of surgery that would be or what you might consider? From our conversations, I think the suggestion for the repair of T12 would be osteotomy or corpectomy of T12 with cage reconstruction done via transpedicular approach. I was a little surprised by that since I thought you would have to approach this level through the ribs. As for the lumbar region, what would have to be done in that area? I understand degenerative changes are common from age 30 onwards but I was shocked to see the black on the scans and the reduced disc space. I am aware that some changes have developed over years but is it also possible for trauma to produce a drastic change or acceleration in the degeneration?
Finally, do you have any opinion on how successful surgeries of this type are? I worry that I might be able to get by now but what about later life? So would I be better off doing something now and going through the recovery while I am still young and strong enough to do so?
Thank you again for your generosity and time.