What could cause walking issues in the elderly?

Hello doctor,

At 68 years old, my mother faces difficulties walking, especially over long distances, and encounters challenges with stairs. Additionally, she struggles to stand unassisted for more than a few minutes, persisting for the past eight to ten months. Despite an eight-month regimen of Gabapin 100 (twice daily) and Dulot 20 (once daily at night) for neuropathy, there has been no improvement. All brain and cervical spine MRI reports and BP, sugar, thyroid, and blood reports appear normal. The attached LS spine MRI and NCV reports are provided for your review. Her right leg exhibits slower movement compared to the left. I am requesting insight into the cause and suggestions for recovery, including potential additional medications. Will physiotherapy offer a complete resolution? Your valuable recommendations for prompt resolution are appreciated.

Thank you.

Hi doctor,

Thank you for your reply.

I am reaching out to discuss my concerns about my mother's health, particularly regarding her cervical spine. Over the past two months, she has been experiencing frequent tingling in her right arm, although she maintains full power in both hands for her daily activities. I kindly request you review her cervical spine MRI report. Considering the issues at C5-C6 and C6-C7, I am curious about the necessity of surgery or if physiotherapy could be a viable alternative.

Additionally, concerning her lumbar canal stenosis, I am considering whether opting for physiotherapy, including strengthening and stretching exercises and balance and coordination exercises, for three to four months could alleviate her walking difficulties and enable her to stand longer without support. I am keen to understand the reasons behind choosing surgery over conservative measures.

Suppose surgery for lumbar canal stenosis is pursued. Could you provide insights into the permanence of resolving neurological claudication and the anticipated improvement in her ability to walk and stand without assistance? Moreover, based on the MRI findings for both the lumbar and cervical spine, I am curious about the locations where surgery might be necessary to prevent future occurrences of similar disk herniation problems.

Regarding the surgical approach, I am interested in whether a minimally invasive procedure, such as microscopic or endoscopic surgery, is advisable. What is the expected post-surgery recovery time for regaining normal walking and standing capabilities? My mother experiences weakness in her right leg, making walking, climbing stairs, and standing without support challenging.

Furthermore, could you provide information on the specific surgery names and locations in the spine where intervention is required to minimize the risk of future spinal issues? While I understand that costs vary, I would appreciate a rough estimate for the surgery, taking into consideration private neurosurgeon hospitals. Additionally, are there any potential risks associated with the surgery post-operation? Lastly, I would like your guidance on whether an orthopedic or neuro-spine surgeon would be the most suitable and safest choice for the proposed procedures.

Thank you.