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Old 04-11-2012, 06:18 PM   #1
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kmg3333 HB User
Help to understand 15 year olds DDD

Hi all,
I am new here, and I am desparate for help from someone to explain to me my daughters MRI's. In August of 2010, my 14 year old daughter was hospitalized after loosing all feeling in her left leg, and a disk tear which ended up as a "goose egg" on her back filled with fluid.
She had a set of 3 spine injections over 3 months at that time, which helped for about a year. She ended up with cushings symptoms, and so we have not had them done since. Weve had 2 MRIs done in 2010, and 2011. She is now going to see a neurosurgeon at U of M Motts childrens hospital. She is barely moving anymore, and cannot keep up. She lives at pain level 6-8 everyday.
I am hoping I can find someone to help me understand her MRI's before we go. I have done alot of reading, but feel like I need someone to give it to me in plain english.
Below is her most recent MRI, done 2/2011 (prior one was 8/2010)

Keep in mind as you read, this all started with no injury, at age 14. I was called home from work because she could not get off of the floor, and lost the use of her left leg, She had a set of 3 steroid shots in L5-S-1 when that happened and her first ever MRI. She ended up with cushings disease symptoms, and so no shots since. She has tried traction, hours in PT and lives now at pain level 6-9 everday. She is just now turning 16.
FINDINGS:

Anatomic alignment of the lumbar vertabrae is appreciated.
The vertabral body heights are preserved
The intervertebral disc spaces show degenerative signal, more pronounced at L3-4 and L5-S1 levels.
Broad based disc annular bulge is present at L2-3 level and midly flattens the ventral aspect of thecal sac.
At L3-4 level asymmetric to the right disc annular bulge with focal central disc protrusion is noted.
There is a mild narrowing of the central canal due to described disc bulge.
At L4-5 level broad based mild disc annular buldge, with suggestion of small central disk herniation, protrusion type.
At L5-S1 level asmemetric to the left disc annular bulge with left foraminal extension is noted. There is mild interval retraction of the voluminous component of the disk bulge that was present in the left paracentral location. There is slightly less pronounced left foraminal component of the bulging disc annulus. The disc annular bulge still mildly flattens the ventral aspect of thecal sac, abuts and mildly flattens the left S1 in the superior lateral recess. The left neural foramen is mildly narrowed at the entrance. The right neural foramen is within normal range.

IMPRESSION:
1. Further interval decrease in signal intensity and height of the intervertebral sic at L5-S1 level. Progressive dehydration of the disc material at L5-S1 results in mild retraction of the left paracentral component of the dic protrusion that was present on the previous exam in August 2010. The disc annulare bulge and the left paracentral broad based disc protrusion are less voluminous.
2. Asymmetric to the left briad based residual disc protrusion and mild osteophytic ridging of the endplates flattens the ventral aspect of the thecal sac and left S1 at the level of superior lateral recess. No evidence of significant central canal compromise. Mild narrowing of the left nueral foramin.
3. Mild narrowing of the central canal at L4-5 level. Mild bioforaminal narrowing, slighly grater on the left, at L-4 level.

*also noted on 8/2010 MRI was a left S-1 Tarlov cyst, not noted on this MRI*

Can anyone help me decipher in english, exactly what is happening to my child>?? I will be eternally greatful for anyones help/advice.

Worried mom of Abbey Elizabeth......

 
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Old 04-11-2012, 09:06 PM   #2
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Re: Help to understand 15 year olds DDD

Hi. I am so sorry to hear what you are going through. I completely understand. I am not a doctor but I am a knowledgeable patient going through a similar situation for the past year and a half, with numerous second opinions and explanations to sort everything out. I have a basic understanding of what the MRI says.

Per the MRI, she has bulges/herniations in a few places in her lower spine. Between each bone in the spine there is a disc. These allow the spine to bend. In the center of each disc is a gel-like substance. When a bulge or herniation occurs, it is usually because some or all of that gel has leaked through the hard part of the disc and is bulging out of the spine. In the case of your daughter, this is pressing against a part of her spinal cord where the nerves run and is constricting them to some degree, on the left side. This is what results in nerve pain down the leg and numbness.

Not being a doctor or having a picture of the MRI, I can't tell you how severe it is or what the solution would be. But a neurosurgeon is definitely recommended as they are skilled in working with delicate nerves on a continuous basis. She may need surgery, but depending on the situation, I have been told that it can be done simply and non-evasively by a good doctor.

Background on my situation: I have lived a very active lifestyle, dancing, soccer, and other sports. Since I was around 20 years old I have had minor lower back pain, but I have never had a major injury or accident. When I was 31 the pain very suddenly became severe and spread to my right hip and leg. My leg went entirely number at one point and I couldn't walk because it was far too painful. Through several drug prescriptions and physical therapy I still live 24 hours a day with pain between 8-9 on a continuous basis. I can't sleep, I can't sit, I can't drive, I can't lift, I can't do anything without severe pain and numbness. This has also started to cause incontinence.

After a few xrays and different doctor's opinions, I finally recently got an MRI and an opinion that made sense. I have an extremely herniated disc (huge bulge) that is blocking part of the nerves coming out of the bottom of my spine. The solution is either physical therapy, which may or may not help, or a non-invasive surgery which simply goes into the back and sucks out the gel that has bulged out. I have opted for the surgery.

In the meantime, what helps me is anti-inflammatories. If not ibuprofen, then definitely anti-flammatory foods (which can be googled). Staying away from foods that inflame is also good. Spicy or fried foods are not good. I personally usually end up taking a heavy ibuprofen prescription (with food always) or Tylenol, just so that I can work without being distracted by pain.

Swim class therapy has also been extremely helpful. I can swim in a pool with almost no pain and afterwards it helps for a little while as it strengthens the muscles I use to hold my spine straight.

I sleep on my back with several pillows propping up my feet. (I'm just giving you whatever I can to help.)

Good luck with the neurosurgeon. I hope things turn out well for your daughter.

 
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Old 04-18-2012, 06:13 AM   #3
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Re: Help to understand 15 year olds DDD

In case you haven't found it, there in a "Back Problems" board where many people with lumbar issues, including DDD, post. If you have questions after your meeting with the neurosurgeon, someone on that board might be able to help you.

When is your daughter's appointment?

 
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Old 04-18-2012, 06:20 AM   #4
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Re: Help to understand 15 year olds DDD

We are leaving today, for an apt. Thursday. Thanks for the advise, I will check that out. I am feeling nervous as I really do not know the "right" questions to ask, Have a better handle now on what is going on as far as the damage to this point, but not what to expect or sugical treatment options. We have done all the non surgical treatments, and her PT says there is nothing more they can do for her. He rated her 50% on the Ostwerthy scale at this point. Hoping for something, anything to relieve her pain and get her back to living some kind of normal life for a 15 year old...

 
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Old 04-18-2012, 08:00 PM   #5
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Re: Help to understand 15 year olds DDD

I will keep my fingers crossed that you find a wonderful spine specialist who will see what is wrong with your daughter, and will have a plan of treatment that will allow her to move forward.

Be sure to take notes as you listen to the doctor or his PA or fellow. You won't remember half of what transpires once you leave the office.

Some possible questions:

If surgery is recommended, how long do you expect it to "last?" Will it need to be redone or revised at some point in the future?

How much will it limit her movement? Will she be able to live an active life, play sports, etc?

What do you expect to happen if she does not have surgery?

Statistically the success rate for this type of surgery is _%. What is your personal success rate, and how many of this type of surgery have you done?

Good luck to you both, and let us know how it goes.

 
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