Is There A Doctor In The House?
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Seems March has historically the month for bad things to go haywire for me. So by March I will find out what’s wrong with these pictures. This is an MRI of my spine. The bottom disc is S1-L5, then there’s a fusion. The next one is not looking good but I don’t know why it’s all dark around the two vertebrae’s? I see the doctor in a couple weeks.
Then there’s the backside view. Pain radiates down to my left knee.
You don’t need a doctor, you need a radiologist. (Since I’m a physician, I get to say that. Radiologists, of course, are doctors — just not real ones. :j)
But really, here’s the deal: Imaging findings correlate very poorly with symptoms. It’s a very tricky deal determining what’s real and what’s not. I was just speaking with a neurosurgeon about this last week and he told me that imaging findings themselves are a MINOR factor in deciding what the diagnosis is. The key: find a good, conservative expert. If you’re in Denver, I’ve got a name for you. It’s very easy to find “something” on just about anyone’s MRI ... even if they feel fine. That’s not to say they’re useless ... just that the answer is ... nuanced.
Sorry to hear about your troubles. I’ve got back issues, too, so I know a bit of what it’s like. Good luck.
Thanks for the response. I haven’t seen the report from their findings yet. I know I look like a sidewinder when I’m standing. I do know from my last issue 10 years ago if I ever hear EMG I’m outta there. That’s Middle Ages torture.
Deertick... You mean when I go to the chiropractor and he draws all those lines on my spine there might not be anything wrong. Say it isn't so.
Another good way of looking at it is a picture of your face tells us what you look like, it doesn't tell us how your feeling. It's the same way an MRI takes a picture of your back, it tells us information but there is A LOT more that goes into decision making than just the picture. It's the reason spine surgeries in general have such inconsistent results, the poor correlation of MRI findings and disability/pain levels. There are plenty of symptom free people that have significant "abnormal" findings on an MRI.
2nd Deertick's advice, find a good conservative spinal/neuro surgeon and see what they have to say. Unfortunately you've already had one fusion, which makes things a bit stickier.
good advice and so well stated too. I know what it's like......it's hard to believe you can have so much pain and not need really major surgery of some kind.
When I was in college, my girlfriend’s dad took a look at my neck and said “there’s nothing wrong with you; you just have a 70-year-old neck!” He did a lot of cervical spine fusions in those days.... WWII Vet.
About 20 years later, a much younger orthopedist (around 70 at the time!) took a look at my hands and told me I had bad discs in my neck. Thenar Atrophy. Film confirmed it.
15 more years down the road, I have neck pain every day.... just like every other day for the past 45 years or so. Nothing for it but to suck it up and live to be 100, eh??
Good luck, man!
Sorry deertick, radiologists are real doctors.
Your pic is too blurry to tell too much, but those are simple reactive changes in the vertebral body endplates associated with degenerative change and scoliosis. What is more important is what is happening with the disc between the vertebral bodies, but can't be determined by your single pics. Your doc visit in a couple weeks should should help with all of these things.
I had diskectomy surgery for herniated disk 5 years ago. Still have numbness and sometimes pain in my left foot if I over do things, but nothing like before. I also have another bulging and a couple degenerated. Weight loss and stretching has helped a ton. .I dont/can't pick up anything heavy anymore. This is tough being an iron worker but it is what it is. Trying not to have another surgery!
Deer tick was just having fun.....I'm sure.
now myself.....I might not be so kind. When I was about 25 I was walking up to a job and got a steering pain in my chest. My partner took me to the ER, it sure looked like a massive heart attack. Weird as I was a Swimmer and water polo player through college- I thought I was pretty heart healthy. Long story but after multiple tests....AND multiple fails at a blood gas test- I started to feel better. EKG was fine.
I finally said forget this [in a little different terms] and left.
3 days later I get a frantic call by the head radiologist at the hospital to get my butt in there NOW. It turns out the Radiologist that reviewed my X-rays totally missed that my left lung had collapsed. They were very apologetic. Heck even I could see the shadow. Turns out I had a flaw in the upper part of my left lung that let go- a fluke....or so I thought.
FFWD to a year ago....my 22 yr old daughter and I are out hiking and she is uncharacteristically falling behind. says she isn't feeling good...got a pain in her chest....
I sped her to the ER against her will- strong little cuss that one...and sure enough- a partially collapsed lung in the same spot as mine. I can't blame her mom on that one.....
Sorry to DL for the hijack....best of luck with your back. If you are in SF or LA...let me know, my buddy Charlie is a renown back surgeon [a hunter too]
The best explanation is go see a good conservative spinal specialist, as stated with the pics are very true.
Myself, just had a spinal stimulus attached to my lower lumbar and the battery inserted just below my belt line over my left buttocks (similar to a pacemaker). I can raise or lower the amount of electrical input to run interference in pain control and getting about 60% relief. Been the last resort before going to the ice flow.
See the specialist and deal with it, the technology has gone along way from a few years ago to get pain relief, life is short and get the most enjoyment as you can.
As Christ promise that we will discard this earthly body that is corrupted for an new heavenly body, amen.
DL You would NOT want to see what the surgeon did to my spine!!!
Beedare not a problem. One of my sons that I though would be my scuba diving partner had a bleb that popped on one of his lungs. I’ve had 24 ortho surgeries since 1980. Haven’t had one for about 3 years since my second staph infection in one of my knee replacements. I was hoping I was done with surgeries. I can handle pain very elk but this nerve pain is just getting old. Tuff getting to sleep at night and walking feels like my leg is on fire. Still not as bad as my last disc issue. That one would just drop me to the ground in agony. Bruce what part of Southern Ca is he in?
Bighorn I have seen some gruesome ones where people with scoliosis had just about all of them fused.
I’m a radiologist. Hard to tell on single view with single sequence. If u have a T2 weighted image or STIR I could tell u more. Probable discogenic degenerative change. Common adjacent to a fused level. However I must include discitis, not knowing your clinical situation and limited view.
Speak English sawbones! lol!
Deertick: "The key: find a good, conservative expert."
So you're saying never trust a liberal. Got it. I read ya, Doc. Loud and clear. ;)
They are making me the report. Degenerative disc Edema Those are two things I heard from the Drs office.
DL - Sorry you're going through this. If you haven't tried it before, Gabapentin works pretty well on the burning nerve pain. So does a spinal cord stimulator. I have both.
I am going through some of these issues and have for years . I will share what I think I know . As we age we tend to have more pain. Get used to it . The best advice I ever go was from a Gp. He said we can wear out or we can rust out . It is far better to wear out. Pain is normal in my life as is exercise. I am convinced that my pain is much less than it could be. I am able to work and hunt now . If I gave up some years ago both would be gone. It is our choice but I will accept a little pain and keep going.
Most likely degenerative disk disease with vertebral body reactive edema as Bullbuster stated. Degenerative disk disease is accelerated adjacent to fused levels because that disk space has increased stress placed upon it because the fused level can no longer move. The adjacent disk space now has the stress of 2 disk spaces placed upon it. Infection (spondylodiscitis) can have a similar appearance on the one image you provided but would look different on some of the other sequences in your MRI study. Your presentation and symptoms would also be different. It's best to go over all this with your local physicians.
I'm an MRI technologist, I see these every day. Your T1 weighted image is of terrible quality to even look at. I'm sure the image is fine, but the screen shot is terrible. A T2 weighted image would be more helpful. And looking at one single slice won't tell the whole story. The most important slices are typically the axial slices, to see what's actually happening at the foramina (where the nerves exit the spinal canal. Your L5-S1 doesn't look bad but it's impossible to really tell with only one sagittal slice. L4-5 is fused and the level that's in question is L3-4. The darkening of the vertebral bodies, on a T1 weighted image is indicative of bone marrow edema. This will correlate as being bright on the T2 and STIR weighted images. In otherwords, that level is not happy. When you have a fusion, typically after certain amount of time, the level above, or below, that fusion gives out. It's the price you pay for a fusion, as the levels above and below are carrying the load of the disc that was fused.
Find a really good spine doc and see what they can do! Good luck!
My heck DL--------->
How much more can one mans body go thru ?
Injury seems to follow you ~~ Dang it.
Keep the faith, Robb