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Old 01-06-2012, 06:48 PM   #1
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Effacement-Cord Deformity, bulges, spurring

Posted this MRI awhile back and did not receive any replies. I have been seeing a spine/pain specialist for a few months, seems they only want to prescribe drugs, then every couple of months do epidural injections. This past week I had an acute event after lifting a few boxes. Cannot live like this anymore. Before I have another set of injections which are the most unbelievably painful, 3 level, huge holes in my neck. Can anyone please give me a little feed back from this mri result. I usually feel frustrated when I leave the paiin centers office and feel I should revisit the surgeon's office, this time I would like to be a little more prepared with questions. Last time the surgeon was discussing possible surgery. Here are the mri results.

C3-4: there is moderate disc bulge in conjunction with bony spurring across midline and preferential to the right with mild right sided foraminal narrowing. This is new as compared to previous study.
C4-5: there is focal bulge in the midline effacing the anterior CSF space coming in contact with anterior aspect of cord causing deformity of the contour of cord anteriorly.
C5-6: there is disc bulge and bony spurring effacing the anterior CSF space and deforming the cord in the midline, unchanged since prior study.
C6-7: this is disc bulge and bony spurring in the midline and preferential to the right which is similar to that seen previously. There is mild right sided neural foraminal narrowing.

LUMBAR - Moderate loss of disc space height at L4-5, which is seen in conjunction with posterior extension of disc material preferential to the left of midline with a contour most consistent with a relatively focal bulge. This deforms the anterior aspect of the thecal sac across the midline and preferential to the left.
Impressison, focal bulge preferential to the left at L4-5 with some deformity of the anterior aspect of the thecal sac at this level. This is seen in conjunction with a component of desiccation and moderate disc space narrowing.

Thanks in advance

 
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Old 01-09-2012, 03:41 PM   #2
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Re: Effacement-Cord Deformity, bulges, spurring

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Originally Posted by Future53 View Post
Posted this MRI awhile back and did not receive any replies. I have been seeing a spine/pain specialist for a few months, seems they only want to prescribe drugs, then every couple of months do epidural injections. This past week I had an acute event after lifting a few boxes. Cannot live like this anymore. Before I have another set of injections which are the most unbelievably painful, 3 level, huge holes in my neck. Can anyone please give me a little feed back from this mri result. I usually feel frustrated when I leave the paiin centers office and feel I should revisit the surgeon's office, this time I would like to be a little more prepared with questions. Last time the surgeon was discussing possible surgery. Here are the mri results.

Sorry but there are only 2-3 of us here who can interpret an MRI and with holiday and cold season upon us, sometimes we aren't around. We are just posters like everyone else but we have learned the hard way what these exams say.

To start with, you have 2 major problems in your spine...one is the disks/bone spurs hitting your spinal cord and the other is the compression of the spinal nerves in your neck. It is the compression of the spinal nerves that causes all the pain...compression of your cord may not hurt at all but can cause other problems such as muscle dysfunction and numbness.

C3-4: there is moderate disc bulge in conjunction with bony spurring across midline and preferential to the right with mild right sided foraminal narrowing. This is new as compared to previous study.

You have a new problem here with compression by a bulging disk and arthritic bone spurs to a mild degree on the right sided spinal nerves. This should be causing pain in the area of your neck and shoulders.

C4-5: there is focal bulge in the midline effacing the anterior CSF space coming in contact with anterior aspect of cord causing deformity of the contour of cord anteriorly.

Here the same kind of bulging disk(as above)along with arthritis bone spurs(as above) are pushing backwards towards your spinal cord. It is actually touching the front side of your cord and they can see it actually deforming the oval shape of your cord. But no measurements are given as to how compressed your cord is so I assume it is normal size, just flattened.


C5-6: there is disc bulge and bony spurring effacing the anterior CSF space and deforming the cord in the midline, unchanged since prior study.

Exactly the same as the area above.


C6-7: this is disc bulge and bony spurring in the midline and preferential to the right which is similar to that seen previously. There is mild right sided neural foraminal narrowing.

At this level, you have the same issue with the cord but with no deformity seen. As with the first level sited, you have compression of the spinal nerves on the right side to a mild degree. This would be causing pain all the way down your arm into the middle, ring and pinky fingers.

LUMBAR - Moderate loss of disc space height at L4-5, which is seen in conjunction with posterior extension of disc material preferential to the left of midline with a contour most consistent with a relatively focal bulge. This deforms the anterior aspect of the thecal sac across the midline and preferential to the left.
Impressison, focal bulge preferential to the left at L4-5 with some deformity of the anterior aspect of the thecal sac at this level. This is seen in conjunction with a component of desiccation and moderate disc space narrowing.

You have a disk that is drying out and shrinking. It has herniated backwards and to the left toward your spinal cord and is touching the membrane(thecal sca) that covers the cord and holds the spinal fluid in around the cord.

Thanks in advance
So here is the bottom line with your neck and lumbar spine. You have 2 areas where the spinal nerves are being compressed but both are "ranked" as being "mild". The 4 levels of severity are minimal, mild, moderate and severe and most spine surgeon will not touch you until you are "severe". As for the cord compression, believe it or not, the cord can take a lot of compression if it goes slowly. Most spinal cords are 10-12mms wide and the cord can take being compressed down to less than half of that....so you don't need surgery there either. Same for the lumbar area....no compression of cord or spinal nerves, yet.

I know you hurt....everyone here has been there. But the docs don't fix it for very good reasons....they can end up paralyzing you in surgery. So they wait as long as possible to do anything. Pain can be dealt with but paralysis is permanent. And there is no guarantee that you will be pain free after surgery either. In fact, surgery to relieve pain is successful in only about 30% of cases. You could end up in even more pain that before surgery.

I hate to tell anyone that they need to work with the pain docs and find a way to cope but that is the reality. I was just reading an article on water therapy and how beneficial it can be for spine issues and I am now doing warm water therapy for my spine so that is something else you might want to look into. Reality is, spines are a real pain.

Sorry to be a downer..................Jenny

 
Old 01-09-2012, 04:21 PM   #3
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Re: Effacement-Cord Deformity, bulges, spurring

Many, many thanks and you were not a downer at all. Actually quite the opposite! You were more detailed than any doctor I've yet to speak with. They have said I will wind up having surgery of which I do not want, I've heard the horror stories.

I also would like to find a way around taking the narcotics, some days are almost pain free while other days if not mindful of what I'm doing, I'm laid out in terrible pain and so frustrated. I believe taking the narcotics for a couple years will only lead to yet another problem to be dealt with.

I've not had anyone recommend water therapy, that sounds like a good idea and I will most definitely check into it this week.

Again, I so much appreciate your taking the time to evaluate the mri and the notes.

Have a nice evening.

Debra

 
Old 01-09-2012, 04:30 PM   #4
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Re: Effacement-Cord Deformity, bulges, spurring

Glad I could be of service. Look into PT in warm water......you can start that way and learn how to exercise in water and then do it on your own if the facility will allow you. Mine encourages it. You want to find a facility that is licensed to do warm water therapy....pool is a minimum of 92* so the muscles don't get cold and freeze up on you causing more spasms.

Has been an absolute godsend for me.

hugs.........Jenny

 
Old 01-09-2012, 04:47 PM   #5
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Re: Effacement-Cord Deformity, bulges, spurring

Gotcha...we have a fairly good facility here, Mid Maryland MI. they have a very good PT department and I believe water therapy.

Can you tell me what areas in my neck are causing the feeling of having a knife in the middle of the shoulder blades? The only way to relieve the pressure and make the headache stop is to hang my head forward. The pain in the middle of my pain is constant and just plain awful.

Thanks again
Debra

 
Old 01-09-2012, 04:49 PM   #6
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Re: Effacement-Cord Deformity, bulges, spurring

I would want a ortho/neurosurgeon's opinion on the severity of the cord deformation. If he didn't quantify it, it's probably not bad, but best to know for sure.

Also, the radiologist says nothing about foraminal narrowing at the two levels (C4-5, C5-6) where the cord effacement is worst. Possible, of course, that there isn't any, but I would want someone else to look at the images of those two levels.

As for your aversion to surgery.... you say you have "heard the horror stories". Sorry, but that is anecdotal evidence, which is the worst kind of evidence there is. OF COURSE you hear about the bad outcomes. That's what people want to talk about, and are most likely to pass along. What you really need is to look at studies (without doubt, there are dozens) that talk about outcomes from multi-level ACDF's (which is what you would get if you got surgery). What are the one-year and five-year outcomes for symptom relief, for post-op pain, and for recurrence? I suspect that it's much better than you think.

Last edited by WebDozer; 01-09-2012 at 04:51 PM.

 
Old 01-09-2012, 08:38 PM   #7
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Re: Effacement-Cord Deformity, bulges, spurring

I've heard horror stories about all the surgeries I've had. If I'd listened to them I would still be having an endless period and bone spurs on each of my big toes that caused excruciating pain.

When I had my endometrial ablation in May of '10 all the stories I read were from women who had horrible experiences which frightened me. I did have the surgery and have been period free since then(which was one of the best things I ever did).

When I had the bone spurs I read horrible stories about people having to crawl around on all fours because they couldn't walk on their feet due to the pain from the surgery. I had both feet done within a 3 months period and never experienced anything like that. I was able to ambulate both times with no problems. As a matter of fact the worst time I've had is when I broke my ankle last June-that was way worse than the 3 surgeries I had because I couldn't take a shower for 4 weeks. With all three surgeries I have had no major complications.

Granted, having an ACDF is major surgery and the complications can be very serious-no one wants to be paralyzed. But when I have a doctor tell me that if I fall or am rear ended again I could wind up paralyzed I'll take the chance of surgery. As for the horror stories we are all different and what happened to someone else in good probability won't happen to you and I'm willing to take that chance.

 
Old 01-09-2012, 09:14 PM   #8
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Re: Effacement-Cord Deformity, bulges, spurring

Sorry...as I said in my post, I had posted this MRI almost a year ago and there were no answers from anyone, I found out I had not posted it correctly. Now I seem to be getting a few good ideas and mainly the support. It is very hard to go through this stuff without people who understand the struggles of living every day with these types of issues.

I appreciate so much your taking the time to reply and share your thoughts. I do believe I am going to take the suggestion to do water therapy. Low impact, anything will be better than doing nothing. Or let say at least I hope! Have a good night and thanks again.

Debra

 
Old 01-09-2012, 11:48 PM   #9
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Re: Effacement-Cord Deformity, bulges, spurring

Quote:
Originally Posted by Future53 View Post
Sorry...as I said in my post, I had posted this MRI almost a year ago and there were no answers from anyone, I found out I had not posted it correctly. Now I seem to be getting a few good ideas and mainly the support. It is very hard to go through this stuff without people who understand the struggles of living every day with these types of issues.

I appreciate so much your taking the time to reply and share your thoughts. I do believe I am going to take the suggestion to do water therapy. Low impact, anything will be better than doing nothing. Or let say at least I hope! Have a good night and thanks again.

Debra

I'm sorry you didn't get any responses then. I'm a newbie-my problems just started in June so that's why I never replied to you. I'm having a 2 level acdf on Wednesday because I couldn't get the pain under control and I have severe compression of the spinal cord at c4-5 and c5-6.

I hope you feel better-being in pain is not fun.

Sue

 
Old 06-07-2012, 09:14 PM   #10
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Re: Effacement-Cord Deformity, bulges, spurring

Hi once again Jenny, it has been quite awhile since I last posted. I did try your suggestiion of warm water therapy (PT) for roughly 6 weeks. First couple of weeks were terrible as far as getting use to the secondary pain of exercising muscles I hadn't used in so long. Amazing how much you don't use certain muscles when you are protecting other things...

Anyway, since I last posted, I've tried the therapy and of course all of my symptoms have actually gotten worse. I was referred out to a pain center and received 3 lumbar injections which actually helped with the exception of being pain free I felt as though I could do more than I should and would throw my lower back out. The injections only lasted a short period (2-3 months). The center was not the best in the long haul. I also have 2 Medial Branch Blocks on my cervical region. They were excruiating and the stress from them actually caused a case of shingles. This center as I said was not on the up and up, in 14 months of seeing them, I only saw the doctor 3 times. I had not seen him for the past 9 months, my visits consisted of seeing the PA every 29 days, narcotic prescriptions written and an injection appt set up if she felt it necessary....so way time to move on as I was just getting worse.

I finally changed centers to the American Spine Center. They actually have surgeons on site, do laser treatments, etc. My first visit just last week, the doctor took one look at my cervical mri and said I am definitely a candidate for laser surgery. Lumbar region will be injections. After complete physical, he was surprised no one had every ordered a Thoracic MRI and sent me for one the very next day!

Of course, I've had paid throughout that area as well and even have gone to the hospital for it on a couple of occassions only to be told it may be an ulcer or may have been a gall bladder attack. I was told this just 6 months ago.

My MRI states I have 3 levels of herniations effacing the cord at T7-T8, T8-T9 AND T9-T10 effacing the cord with spurring. What I don't understand is, it also states immediately following this "uncertain clinical significance. Please see axial images #2, #10 and #16 respectively. Can you answer this for me?


All of that to ask one question, so sorry, hope you got this far.

Deb




QUOTE=jennybyc;4907639]Glad I could be of service. Look into PT in warm water......you can start that way and learn how to exercise in water and then do it on your own if the facility will allow you. Mine encourages it. You want to find a facility that is licensed to do warm water therapy....pool is a minimum of 92* so the muscles don't get cold and freeze up on you causing more spasms.

Has been an absolute godsend for me.

hugs.........Jenny[/QUOTE]

 
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