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Old 03-21-2012, 02:25 PM   #1
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Question Need help understaing MRI results for Mid-back pain

I have been dealing with middle back pain for over a year it hurts right on the spine and it is there all the time I have been to multiple doctors, the last one suggested Steroid Epidural Injections because she didnít know what else to do and she didnít think that my pain was coming from the bulging disk in my middle back, so I figured we will give it a try. Well the doc doing the injection couldnít get it to go in the spot he wanted it to so he had to try 3 different spots to finally get it to go in. I will never have that done again plus it didnít help. About a week later I started getting numbing in my left had and left foot then it started to move down my arm and up my leg so my husband took me to ER they did a catscan and said everything looks ok but to see a Neurologist. By the next day I had numbing in both hands and feet up to my knees. I called the doc that gave me the injection to see if that injection maybe caused it so he ran another full back MRI to double check for blood clots nothing was found and they said the MRI didnít change from the one 6 months ago. So went to Neurologist appointment doctor said my refluxes and everything look good she was going to run a bunch of blood work. That came back saying my Vit D is low along with my B12. She thinks thatís what is causing my pain. Tried vitamins for 2 months (numbness went away not the back pain) we decided to try Gabapentin that didnít help and I started getting bad headaches, so she switched me to Lyrica which was going ok but then I had a new problem I had burning pain in my right shoulder between my shoulder blade and neck at times it spreads down my shoulder but it usually stays on top and to the back it is constant I never have relief. I tried Icy/Hot that was the worst idea that hurt so bad I had to jump in the shower to get it off me. This burning pain has now gone on for at least 2 months. I listed below details of my MRI I am just at my wits end and sick of being in pain I have a 3 year old at home and I canít do the things I should be doing with her . Even my chiropractor said he canít believe they are telling me my bulge isnít causing my pain. Sorry for the novel just wanted to make sure I got everything in.
[U][B]6/1/11 MRI[/B][/U]
At level T6-T7 there is disc desiccation. There is a small focal left paracentral disc protrusion. It is causing a compressive effect on the thecal sac, and is slightly touching the cord. Signals in the cord appear normal.

At level T7-T8 there is a mild desiccation


[U][B]1/4/12 MRI[/B][/U]
At T6-T7 there is a disc desiccation. There is a moderate posterior and left paracentral dis herniation. This attenuates the anterior subarachnoid space and results in mass effect and flattening of the anterior and left thoracic cord. Posterior suarachnoid space is well maintained

At C5-6 there is a minimal broad-based posterior and circumferential disk bulge. This only partially attenuates the anterior subarachonoid space and results in no mass effect upon the cervical cord.

Thanks for taking the time to read my story I would appreciate any help or input.

 
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Old 03-21-2012, 03:27 PM   #2
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Re: Need help understaing MRI results for Mid-back pain

Hi. I'm Jenny and I post here sometimes and am a regular on the Spinal Cord Disorders board where most of those with neck issues post. I have more herniated disks in my spine than none herniated, including my entire neck(now fused C3 to T1) and T 6,7 and 8(and all 5 lumbar). So let's start with what your MRI says.

At T6-7, you have a disk that is herniated and was touching the thecal sac(membrane that covers the cord) and has now progressed to touching the front and left side of your cord. The symptoms pf this problem would be things like numbness in your toes or stiff leg muscles and possibly trouble walking. It would not produce pain as it's not touching the spinal nerves, only the spinal cord. So symptoms show up in the areas below that level of the cord and since the pressure is transferred inward, it tends to show up in the feet first as numbness, tingling, pins and needles and trouble moving your toes.

BUT...and it's a big but...IF the pressure is sufficient to cause trouble. Your cord can take a good bit of compression before anything shows up. My cord was compressed to less than half normal thickness in my neck and I had symptoms similar to what I've mentioned. No cord dimensions are even given so I doubt you have that kind of compression...it would have been noted in the report.

At C5-6, you again have a disk bulge but it isn't touching anything...not the cord or the spinal nerves so it shouldn't be causing any symptoms.

Your T6-7 problem may cause some back pain but it is not the cause of the problems with your legs and certainly not your arms...neither does C5-6.

With all the tests they've done, has anyone done a bone density to see of you have osteoporosis? B 12 deficiency can cause a ton of very serious problems including paralysis and should be more thoroughly investigated. Intermittent numbness like yours sounds more like a B12 problem than anything with the spine.

If your back hurts to the touch, I'd worry about osteoporosis but the numbness...that's not your spine at all. Doesn't match any of the nerves served by the spine.

Go make your docs work and figure out what this is.....it's not your back.

Jenny

 
Old 03-21-2012, 03:42 PM   #3
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Re: Need help understaing MRI results for Mid-back pain

The MRI is but one piece of the puzzle...and none of us on here are doctors, so please take that into consideration as you read on the board.

Have you been seen by an spine specialist? This would be an orthopedic spine surgeon or a neurosurgeon whose practice is limited to the neck and back.

I've had many ESIs and nerve blocks into the lumbar spine. I think it sounds like the doctor may have gotten the needle into the subarachnoid space when he/she was fishing around trying to find the right spot. Was this done with fluoroscopy? This is very irritating to the affected nerves. Or perhaps you had a generalized reaction to the dye that is used for the needle placement, or to the steroid or something in the steroid....there are many possibilities.

Compare these two reports:

[B]6/1/11 MRI
At level T6-T7 there is disc desiccation. There is a small focal left paracentral disc protrusion. It is causing a compressive effect on the thecal sac, and is slightly touching the cord. Signals in the cord appear normal.[/B]

and...

[B]1/4/12 MRI
At T6-T7 there is a disc desiccation. There is a moderate posterior and left paracentral dis herniation. This attenuates the anterior subarachnoid space and results in mass effect and flattening of the anterior and left thoracic cord. Posterior suarachnoid space is well maintained[/B]

It may just be a difference in the radiologist who read the MRI...but it looks to me as though there is some progress in the disc herniation --it has gotten somewhat larger...and is now pressing into the anterior and left thoracic cord. In the MRI from 6 months earlier it was only slightly touching the cord and the herniation is referred to as "small" as opposed to "moderate."

It is for subtle differences such as these that I suggest you take your MRIs and go see a spine specialist. If you have already done that, I suggest you go to another one for a "second" opinion.

 
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