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    Old 04-24-2012, 06:14 PM   #1
    buddikay
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    Question Please help with thoracic and lumbar MRI

    Hello I am new and browsing threads hoping to gather information to help me understand my MRI.
    Background: I went to ER with extreme burning pain in back, rt hip, rt leg and both feet. I could hardly walk. Felt like hot coals in my back, hip and down my leg to my feet. They gave me pain relief thinking it was my fibromyalgia, no tests.

    A few days later it was even worse. Burning in neck, back, ribs and chest, rt shoulder, arm, hip, leg, and both feet. Also had numbness, pins/needles from head to toe all on right side but also pain/numb in left foot. They said go back to ER but I insisted on getting in to see my doctor who was familiar with my FM and he agreed with me that it was not FM related. Ordered MRI, prednisone, flexeril, naproxen, percocet.

    Doc called about MRI, said he was sending me to neurology next day because I had discs protruding into my spinal cord at t5-6 and said be careful not to fall, bend, twist, or lift. Now I'm scared.

    Neuro did tests on me, found rt sided weakness. Went over MRI and said it is rare to have protrusion like this happen in thoracic area, and that is what's causing the burn in my back, ribs and chest. He then repeated what doc told me about being careful not to bend etc. When I asked what they do to fix it he said it depends on the quality of life I want to get back to. He is sending me to physical therapy. And put me on neurontin for burn pain.

    Does this mean they can't fix it? I am limited in mobility. I had to get a temp. disability plaque. I had to limit anything physical. I cannot work. I can barely be on my feet more than 15 min. without pain hitting and then I can't move for hours. I have to use a walker or assistance to get to the bathroom on those days.

    THORACIC SPINE MRI WITHOUT IV GADOLINIUM
    ** FINDINGS **:
    Thoracic MRI was performed without IV gadolinium on a GE 1.5 Tesla
    magnet.
    This a right paracentral disc protrusion at T5-6 which results in
    mild to moderate thecal sac compression, and indents the right
    ventral spinal cord at that level (axial image 14 of series 7). No
    fracture, bony lesion or malalignment. There is mild disc
    degeneration in the mid and lower thoracic spine. There is no
    abnormal spinal cord signal. The conus medullaris is located at
    T12 with normal signal. No neural foraminal narrowing at any
    level. No significant thecal sac compression at other sites.
    ** IMPRESSION **:
    1. Right paracentral disc protrusion at C5-6 results in mild to
    moderate thecal sac compression and indents the right ventral
    spinal cord at that level.
    2. No neural foraminal narrowing at any level.
    3. There is mild disc degeneration in the mid and lower thoracic
    spine.

    LUMBAR SPINE MRI
    ** FINDINGS **:
    Lumbar spine MRI was performed on a GE 1.5 Tesla magnet without
    contrast.
    No fracture, bony lesion or mass. There is mild disc degeneration
    at L3-4 and L4-5. The conus medullaris is located at L1 with
    normal signal. Axial images show the following:
    L2-3: Normal.
    L3-4: Minimal thecal sac indentation anteriorly due to small
    circumferential disc bulge. There is ligamentum flavum thickening
    and mild bilateral facet arthropathy.
    L4-5: Minimal thecal sac indentation anteriorly due to small
    circumferential disc bulge. There is mild bilateral facet
    arthropathy.
    L5-S1: No thecal sac compression. There is mild bilateral facet
    joint arthropathy.
    ** IMPRESSION **:
    Mild lower lumbar disc and facet joint degeneration. No
    significant thecal sac compression. No neural foraminal narrowing.


    CERVICAL SPINE MRI WITHOUT GADOLINIUM
    ** FINDINGS **:
    Cervical spine MRI was performed on a GE 1.5 Tesla magnet without
    IV gadolinium.
    No fracture, bony lesion or malalignment. No significant disc
    degeneration at any level. No abnormal spinal cord signal or
    cerebellar ectopia. No thecal sac compression or neural foraminal
    narrowing at any level.
    ** IMPRESSION **:
    No thecal sac compression or neural foraminal narrowing at any
    level. No significant disc degeneration.

    Last edited by buddikay; 04-24-2012 at 09:08 PM.

     
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    Old 04-24-2012, 06:36 PM   #2
    kenzibenzi
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    Re: Please help with thoracic and lumbar MRI

    I wish I had your spine, especially the cervical spine! I have degeneration, disc narrowing, pinched nerve and herniated disc at T7-8 so I totally understand your pain there. Only difference is that my dr refuses to give me anything for pain except antidepressants, which make me feel ill.

    Is the neurontin helping? Probably hard to tell what is helping since they gave you so many different meds. I've been told there isn't much that can be done with the thoracic spine. I goggled and found a clinic in Ohio that will do surgery on the t-spine. Did you do the therapy and is it helping? I bet after the prednizone runs it's course you will be feeling better, at least I'm hoping so.

    I'm no expert, but your mri' doesn't look half bad. And your cervical spine is perfect! Can I have it?

    Do keep us posted. I hope you're feeling better tonight.

     
    Old 04-24-2012, 07:09 PM   #3
    buddikay
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    Re: Please help with thoracic and lumbar MRI

    What's funny is they actually first thought I had problems stemming from the cervical area but it was fine. Yes the neurontin is helping. And the prednisone etc helped with inflamation they said I had and I had horrible spasms so flexeril which I am used to for fibromyagia anyway. But I feel so limited now with the thoracic. I'm afraid to move certain ways. They have me so scared that if I fall I could have paralysis. So now I'm just very careful. I find the more I move around the more it is aggravated and pain, pins/needles start all over again. So really very limited now.

    Last edited by buddikay; 04-24-2012 at 07:11 PM.

     
    Old 04-24-2012, 07:29 PM   #4
    kenzibenzi
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    Re: Please help with thoracic and lumbar MRI

    Sounds like you are improving, so stay on the meds and hopefully the inflammation will go down and you will get all your range of motion back. Even with all my problems, and I do have many, I am very hard on my body. When I pinch a nerve it stops me dead in my tracks...lol. You know that feeling! When I see my doc on the 15th, I'm gonna ask about neurontin and flexeril. I need surgery on my cervical spine (that's on the spinal cord injury board) and they still give me nothing for pain. Thank god and your lucky stars that you have a dr who gives you relief. I'm so happy to hear that you're feeling better! Keep up the good work and keep us posted! ~hugs, Kenzi.

     
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    Old 04-24-2012, 09:19 PM   #5
    teteri66
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    Re: Please help with thoracic and lumbar MRI

    I would suggest that you make an appointment with a fellowship-trained orthopedic spine surgeon or a neurosurgeon whose practice is limited to the neck and back. They are the two specialists that have the most training and experience with issues pertaining to the spine, will provide the most accurate diagnosis and method of treatment.

    Overall your radiology reports from the MRIs look quite good, with the exception of the herniation at T5-T6. You do have disc bulges at other levels, but they are mild and judged not to be causing any issues.

    Radiologists use certain language to designate the general amount of severity of a problem. It goes from minimal, to mild, moderate and severe. Minimal and mild issues are noted but generally do not require much, if any treatment. Moderate may require types of conservative treatment and severe can often be a sign that surgery may be necessary.

    Note:the indication of a protrusion at T5-T6 means that the disc between the thoracic 5 vertebra and the thoracic 6 vertebra is degenerating. (each segment or level consists of the two vertebrae separated by a disc -- like an oreo).

    In your case, the disc bulge is pressing into the thecal sac and indenting the spinal cord. Since the nerves are traveling through this area, it results in the nerve pain you are experiencing. This indentation can become dangerous if it would push on the nerves to the point that function is seriously affected and the signal to the brain is broken. I think the spine surgeon will be able to tell you the extent to which this is likely to happen.

    Surgery is infrequently done on a thoracic disc problem due to the difficulty there is in reaching it. However, I understand there are some new techniques that are making this easier. Depending on where you live, it may be necessary to travel to a larger city in order to find a spine specialist that is up to date and experienced with the latest technical advances in thoracic surgery.

     
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    Old 04-24-2012, 09:27 PM   #6
    buddikay
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    Cool Re: Please help with thoracic and lumbar MRI

    Thank you for your reply. Your explanations is more than the neuro explained. He acted like I should know what he was talking about and it was very confusing. Is a disc protrusion like I have the same thing as a herniated disc? I'm trying to educate myself so I apologize if I sound ignorant.

    Last edited by buddikay; 04-24-2012 at 09:32 PM.

     
    Old 04-24-2012, 10:12 PM   #7
    teteri66
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    Re: Please help with thoracic and lumbar MRI

    You do not need to apologize. I think most of us were in the same boat when we first developed spinal problems. The terms for a bulging disc get complicated as some are used interchangeably; some terms mean different things in the US than they do in the UK, etc. Neurologists tend to not be great communicators.

    Forget about the oreo and now think about a jelly doughnut. The disc is comprised of a tough outer fibrous ring that contains a softer, gel-like center. In a healthy disc, the jelly center comfortably fits inside the dough.

    When the disc bulges, it tends to look like a giant hamburger that is too big for the bun. It extends beyond the space it is supposed to occupy. It can bulge in different areas, so, for example, it might press on the left side, the right side or just be more centrally located. It is usually the tough outer ring that is bulging...and a bulging disc is much more common than a herniated disc. This is also called a disc protrusion. The spinal disc remains intact.

    The herniated disc has gone one step further and there is now a crack in this outer layer which allows some of the soft inner core to squish out of the disc. This is usually in a smaller, more distinct area than the bulge...which displaces a larger area (think of when you push on a water balloon and one side bulges out...but does not break open). There are degrees of herniation, too, called extrusion and sequestration being the most extreme. Herniated disks are also called ruptured disks or slipped disks.

    Hope this helps! If you are interested, you can find some excellent info online including some animated videos that show the "stages" of disc degeneration, etc. I think it helps to look at a diagram of spinal anatomy so you can picture what the disc, or vertebra or thecal sac look like.

    P.S. The "warning" you received from the doctors is that right now your disc is just in the stage where it is bulging. If you were to fall or have some sort of impact accident, the concern is that the disc could rupture and maybe a fragment would break off into the spinal cord.

    This is always a concern with any disc herniation in the cervical or thoracic region, but not in the lumbar or sacral regions because the spinal cord ends around the T12-L1 vicinity...so with a lumbar issue there is less chance of any paralysis becoming an "issue." (It may be that doctors automatically "warn" patients of this potential problem even when the likelihood of it happening is slim just to protect themselves. I'm just guessing here since I only have lumbar issues and there isn't that potential for paralysis that you can have with cervical or thoracic issues.)

    Last edited by teteri66; 04-24-2012 at 10:21 PM.

     
    Old 04-25-2012, 10:42 AM   #8
    buddikay
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    Thumbs up Re: Please help with thoracic and lumbar MRI

    I sure wish the doctors would be this informative so we aren't left with wondering where to go from here. Thank you so much for your help in understanding. I am looking things up on the internet to learn more. That is how I found this site and so far this site has been the most helpful. I just don't understand alot of the medical terms but you describe them in a much easier way that I can actually picture what you describe.

    Last edited by buddikay; 04-25-2012 at 10:44 AM.

     
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