<s>[INST] i had an xray  done i had a spinal fusion done in1982, with very little problems but now i am in worse pain then before, l1 apperanance of  rudimentary ribs, anterior and posterior  spurs l2-l5 disc space narrowing l3,l4,l5 and s1. sacralization l5  what does this mean? [/INST] Hello! Welcome on Chat Doctor ! Your symptoms are related to chronic degeneration of the cervical spine. I don't think that surgery would help in this situation. The best thing to do would be physiotherapy. I would also recommend trying duloxetine or Gabapentin for the pain. These Chat Doctor.  You should discuss with your doctor on the above issues. Hope you will find this answer helpful! Kind regards,  </s>