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  • Thoracic Injury- Need Help

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    Old 09-22-2011, 08:12 AM   #1
    Thoracic2011
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    Thoracic Injury- Need Help

    Hello All, I am new here. I had a Thoracic injury several years back. Due to the severity of the injury they referred me to the local University as no Ortho doctor would touch it. This was after 80+ rounds of PT, seeing multiple Ortho Docs, etc.
    My question is this: I have developed severe pain in both of my legs, more in my right than left. I take 50mg Kadian twice daily, Tramadol 4-6 times a day for BT, Naproxan, etc. I have had weakness in both legs but that weakness has now turned into pain, very severe at times. Also have bladder problems. Of course, I also have the severe Mid to lower back pain that radiates into my ribs. I have grown to deal with that. Surgeon has wanted me in the OR for the last 2 years but due to the complications, I am holding off as long as possible. The Pain Mgmt. doctor says he has a problem correlating the pain in my legs to my Thoracic Spine. He said if it was a Lumbar injury he could see it. Does anyone have any thoughts on this? Everywhere I look supports I am not crazy. I would appreciate any input.

    Here are my last MRI Results: (The worse of it is at the end)
    T1-T2: Small right paracentral disc protrusion is noted with mild sac narrowing.
    T3-T4: Small right paracentral disc protrusion is noted with mild sac compression.
    T4-T5: Left paracentral disc protrusion is noted with mild sac compression.
    T5-T6: Small right paracentral disc protrusion is noted with mild flattening of the ventral cord.
    T6-T7: Right paracentral disc protrusion is noted with superior migration causing mild flattening of the ventral cord.
    T7-T8: Broad disc osteophyte complex is noted with mild flattening of the cord.
    T9-T10: Left paracentral disc buldge is noted with mild sac compression.
    T10-T-11: Moderate Canal Stenosis is noted secondary to disc oteophtye complex and hypertrophled facet joint. Mild cord compression is noted. Bilateral foramina are unremarkable.
    T11-T12: Left Paracentral and left foraminal disc oteophyte complex is noted with severe canal stenosis and cord compression. Bilateral facet arthropathy is noted. Severe foraminal narrowing is noted on the left and moderate on the right.

    Questionable increased T2 signal is noted within the cord at the level of T11-T12.

    Pre- and paravertebral soft tissues are unremarkable.

    Impression: Degenerative changes of the Thoracic Spine, the most significant level is at T11-T12 where there is severe canal stenosis/cord compression and severe foraminal narrowing. Suggestion of subtle increased T2 signal within the cord at this level.

     
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    Old 09-22-2011, 08:22 AM   #2
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    Re: Thoracic Injury- Need Help

    Sure looks like a serious problem at T11-12. I don't know if he means for "severe" to apply to just the canal compression or also to the cord compression. If it's the latter, then a real red flag. You should be able to tell, yourself, by looking at the images.

    Anyway, T11-12 is "almost" lumbar, and it makes one wonder what a lumbar MRI would show at adjacent levels.

     
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    Old 09-22-2011, 08:34 AM   #3
    Thoracic2011
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    Re: Thoracic Injury- Need Help

    Thank you for the reply. The "severe" does mean the cord also. That's also where the complexity of the surgery comes in as there is not alot of room for error at this level with everything going on. You can see on the MRI where the cord is Severely Flat at level.
    Lumbar MRI shows everything 100% normal from L1 to L4 with a slight disc bulge at L4-L5. L5-S1: Marginal Osteophyte disc complex. No evidence of central canal stenosis. Mild to moderate bilateral foraminal stenosis. Facet arthrosis.
    Thank you again for any input you have.

     
    Old 09-22-2011, 08:44 AM   #4
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    Re: Thoracic Injury- Need Help

    Is T12-S1 OK? Of course that's the additional one that's most likely to be out. Any idea how T11-12 got so bad? Some kind of trauma?

    Your T11-12 disk, which is so far out of whack, will press on the T11 nerve root, which has nothing to do with the legs.

    However, if you have severe cord flattening, I don't see why anything below that level is not susceptible. I have cervical cord damage, and as many symptoms in my legs as in my arms. Maybe something to clear up with the docs.

    Also, your moderate bilateral lumbar foraminal stenosis is not as good as it sounds, as "moderate" is only one step below "severe".

    Last edited by moderator2; 09-22-2011 at 08:52 AM. Reason: please do not post a commercial website, for any reason.

     
    Old 09-22-2011, 08:54 AM   #5
    Thoracic2011
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    Re: Thoracic Injury- Need Help

    I was lifting a heavy piece of equipment and it slipped from my hands. I caught it before it hit the ground. Biggest mistake of my life! Been out of work ever since. Thank you for your input. Everything I read supports what you are saying and what I am trying to tell him. He wants me to get a EMG (Electromyogram) and a NCS (Nerve Conduction Study). I'm not sure how this is going to help?

     
    Old 09-22-2011, 09:01 AM   #6
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    Re: Thoracic Injury- Need Help

    I dunno.... it can't hurt, though, unless it gives him the wrong idea. I'm curious, though, about what it would tell someone in your situation, so I hope you will post the results.

     
    Old 06-04-2012, 02:11 PM   #7
    Sunnyhill28
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    Re: Thoracic Injury- Need Help

    Hi! Did you find out if your T11 T12 cord compression was to blame for your pain? I have LBP around my right hip that can radiate down as far as my ankle. The "worst finding" on my MRI was cord compression @ T11 T12. I am just curious if my pain is stemmed from this or the disc bulge @ L5 S1 (which would be closer to the area of my pain.

     
    Old 06-04-2012, 04:29 PM   #8
    Thoracic2011
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    Re: Thoracic Injury- Need Help

    Quote:
    Originally Posted by Sunnyhill28 View Post
    Hi! Did you find out if your T11 T12 cord compression was to blame for your pain? I have LBP around my right hip that can radiate down as far as my ankle. The "worst finding" on my MRI was cord compression @ T11 T12. I am just curious if my pain is stemmed from this or the disc bulge @ L5 S1 (which would be closer to the area of my pain.
    It depends on which doctor you talk to. My surgeon says it is possible to incur such pain as his belief is that anything below the injury site can be affected. My pain management doctor does not 100% agree with this. As soon as I talk to him about my leg pain he keeps telling me that my lower lumbar looks good and it must be from something else. It's funny you posted today as I left my Pain Management doc today and I let him know my legs are getting worse so now he wants a Ultrasound to rule our Blood Clots! He does not 100% buy into the fact that it is from my severe Thoracic injury. I'm really sorry I can't give you a definite answer but it seems that's the way it is with this type of injury.

     
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