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It is controversial whether a fusion is actually necessary in the case of a stable degenerative scoliosis with stenosis but the accepted approach is to perform a fusion If an instrumented fusion is considered it would require at least a T11-pelvis fusion

[121] Age is also a contributing factor: elderly individuals are often achlorhydric due to reduced parietal cell function in the stomach, increasing their risk of vitamin B 12 deficiency

It is an intracellular metabolic-enzyme modulator, which is why its research read-outs are things like NAD+ levels and adipocyte gene expression, not how full you feel. That mechanistic distinction is the single most important thing to understand before looking at any dose number

Apart from that, it may also show neuroprotective properties and act as an agent against collagen production