Medical Questions > Conditions and Diseases > Back Pain Forum

Kink In Spinal Cord, Focal Kyphosis, Stenosis, Fissure -help

Must Read
What structures make up the spine? We review basic spine anatomy here...before identifying potential causes of back pain....
Click here to learn about the most common causes of back pain, and things that increase your risk of backache. We cover lower back pain and upper back pain....
Back pain symptoms may seem obvious. But do you know when symptoms of back pain are more serious or when to see a doctor? Learn what action to take & when...
I have come to this site in search of suggestions and input on back pain & other symptoms that might possibly be related to the condition of my spine. I know this will be a long post, but I am in serious need of help, PLEASE bear with me, as I want to be as through as I can. I do not expect a diagnosis; I know that is not feasible. I have seen 2 orthopedic MDs within the last 3 years, and an orthopedic surgeon. They have no ‘treatment’ answers for me, just ‘live with it’ & ‘take pain medication as needed’ type answers. I would like to improve the quality of my life, and feel that I am at a point where I need to try and find suggestions & maybe even answers on my own, if possible. I also have GI & Neuro symptoms that I am wondering about being related to the spinal condition. I am including here the reports for the Cervical, Thoracic & Lumbar MRI’s I have had done in the past year. I will follow those with my history & more info & questions, please read on.

MRI CERVICAL SPINE WITHOUT CONTRAST
TECHNIQUE: T2 sagittal, T1 sagittal, T2* axial, STIR sagittal

The cerebellar tonsils terminate above the foramen magnum. The spinal cord demonstrates normal signal & caliber throughout it’s visualized course. There is straightening of normal lordotic curvature. The vertebral body heights & alignment is normal. The bone marrow signal is normal throughout.

C2-3: No disc protrusion. Spinal canal & neural foramina are normal.

C3-4: There is a small posterior disc osteophyte complex. The spinal canal is mildly narrowed to 8mm. There is mild narrowing of the bilateral neural foramina secondary to uncovertebral osteophtyes, slightly more prominent on the left.

C4-5: Small broad posterior disc osteophyte complex is present, which narrows the spinal canal to 8mm. There is mild narrowing of the bilateral neural foramina secondary to uncovertebral osteophtyes. Mild right neural foraminal narrowing is present.

C5-6: Small broad posterior disc osteophyte complex is present, which narrows the spinal canal to 8mm. There is moderate-to-severe left neural foraminal stenosis uncovertebral osteophtyes. Mild right neural foraminal narrowing is present.

C6-7: Small posterior disc bulge is present. The spinal canal is mildly narrowed to 8mm. There is mild-to-moderate left neural foraminal narrowing. The right neural foramen remain normal caliber.

C7-T1: Disc, spinal canal, neural foramina are normal.

The facet joints are unremarkable. Congenitally short pedicles contribute to multiple levels of spinal canal stenosis as described above.

Impression:
1) Multiple levels of foraminal stenosis as detailed above.
2) Multiple levels of mild spinal canal stenosis secondary to small disc osteophyte complexes and congenitally short pedicles as described above.

MRI THORACIC SPINE WITHOUT CONTRAST
Technical data: Sagittal T1, sagittal T2, Sagittal STIR, axial T1, and axial T2

FINDINGS: The vertebral body heights are maintained. No compression deformity is visualized. There is no evidence of bone marrow infiltrating lesion. No edema is visualized on the inversion recovery weighted images. There is a small Schmoral node involving the inferior endplate of T7.

There is focal kyphosis of the thoracic spine centered at T7-8. At this level, there is a central disc protrusion/disc osteophyte complex measuring approximately 4mm in AP dimension. This causes moderate spinal stenosis with the AP dimension of the spinal canal measuring approximately 5-6 mm. There is no neural foraminal narrowing. The disc does abut the ventral surface of the spinal cord at this level; no abnormal signal intensity of the spinal canal is seen.

At T6-7, there is a small, 2 mm right paracentral disc protrusion. There is no neural foramen narrowing or spinal canal stenosis. The AP dimension of the spinal canal measures approximately 8mm.

At T9-10, there is a 1 mm right paracentral disc protrusion without evidence of spinal stenosis or neural foramen narrowing.

The remainder of the visualized thoracic disc spaces appears unremarkable.

IMPRESSION:
Focal kyphosis at T7-8 with a broad-based central disc protrusion causing moderate spinal stenosis at this level. The focal kyphosis causes a kink in the spinal cord best visualized on the sagittal T2 weighted images. No abnormal signal intensity of the spinal cord is present.

MRI LUMBAR SPINE WITHOUT CONTRAST
TECHNIQUE: T2 Sgittal, T1 sagittal, T1 axial, T2 axial, and STIR sagittal.

FINDINGS:
Conus medullaris terminates normally at L1-2. Nerve roots are normally configured within the thecal sac. There is normal vertebral body height and alignment. The bone marrow signal is normal throughout.

L5-S1: There is no significant disc protrusion The spinal canal and neural foramina are normal. There is severe hypertrophic degenerative disease of the facet joints bilaterally.

L4-5: Broad posterior disc protrusion is present measuring 3-4mm. A periphery of abnormal signal intensity represents a small annular fissure. Moderate left foraminal stenosis is seen. There is mild-to-moderate right foraminal stenosis. The spinal canal is narrowed to 7mm. Small amount of CSF is maintained surrounding the nerve roots. There is severe hypertrophic degenerative disease of the bilateral facet joints, which contributes to the spinal canal stenosis. Additionally, there is moderate left lateral recess stenosis and mild right lateral stenosis.

L3-4: No significant disc protrusion. The neural foramina are of normal caliber. There is mild narrowing of the spinal canal to 8mm with CSF maintained surrounding the nerve roots. Sever bilateral hypertrophic degenerative disc disease of the facet joints is present, which contributes to the spinal canal stenosis.

L2-3: Disc, spinal canal, neural foramina are normal. There is severe facet arthropathy.

L1-2: Disc, spinal canal, neural foramina are normal. There is severe facet arthropathy.

T12-L1: Minimal disc bulge is present. The spinal canal and neural foramina are normal.

IMPRESSION:
1) Mild degenerative disc disease, most pronounced at L4-5 with protrusion and annular fissure.

2) Bilateral neural foraminal narrowing and lateral recess stenosis at L4-5.

3) Mild spinal canal stenosis at L3-4 and L4-5

4) Severe facet arthopathy throughout the lumbar spine.


HISTORY:
I have had long standing upper back pain (about the level of my bra strap in the back, and in between my shoulder blades) I also have an area of decreased sensation (numbness) on the left side of that same area (mid back, left of spine, about shoulder blade level & lower, covering an area about the size of a large mans hand) I have occasional sharp pains in and around the spine in that area, but mainly the pain is an intense ‘ache’ of the upper back region. It increases with activity that involves using my arms, such as driving, folding laundry, washing dishes etc. I can barely tolerate anything that requires use of my arms and holding weight combined, such as holding an infant or child, even of newborn weight. I am not positive of when the pain started, possibly as much as 10 years or so ago, and do not know if it was caused by an injury at some point in my life. I was doing heavy lifting at work when the intensity & frequency of the pain increased by a lot. (I no longer do heavy lifting) Within the last 1-1.5 years it has significantly increased to where it is now a daily situation, especially if I am active (like cleaning house, cooking, driving etc.) I have also noticed (more recently) pain in the sternum area, mostly with a deep breath or certain movements. It is a sharp pain that radiates along the general sternum area, not just one specific spot on the sternum. (it is definitely in the middle of my ribs- cardiac causes have been rule out so far) I have occasional tingling on the bottom of my right foot, literally right down the middle of it.

TREATMENTS:
I have had 2 epidural injections in the T7-8 area, with no pain/symptom relief. I have tried a TENS unit & a muscle stimulator of some sort that was to relax the back muscles. Neither device offered me any relief, and in fact the TENS unit caused sharp pain where the nerves were being stimulated, even when on low intensity. It seems to have caused pain to shoot into my arms & legs also, along with tingling sensations. This tingling lasted for a few months, even after I discontinued using the units, so we do not know for sure if the units were the real cause of the tingling. The TENS unit definitely caused the nerve pain. Because of the ongoing tingling I was referred to a neurologist. (more info below) PT was also prescribed at some point, but the physical therapist said after my first evaluation that there was nothing she could do for me. The orthopedic surgeon said he did not feel I was a surgical candidate (in regards to my thoracic pain, which is what bothers me the most) unless at some point I was to become paralyzed. Since I would resist surgery until I was 100% sure all other options had been exhausted, I was ok with this. But really feel I deserve to know what my other options are, if any!!

OTHER INFO:
I have had 4 years of GI problems. Main issue is regurgitation of food, without heartburn. Basically, after I eat, food will come back up into throat & sometime mouth, starting about 30 minutes after I eat & continuing for an hour or two afterwards. I am being followed by a GI, and have had upper endoscopy. They don’t know what is causing these symptoms. I only mention it here because I am wondering if it could be related to the trouble with my back in ANY WAY. I have read that sometimes problems with one’s spine can cause other systemic issues, like heart, GI etc. problems. I don’t know if this is true, and would like to know.

I was referred to a neurologist due to the tingling in my hands & feet that started after I began using the TENS unit. A nerve conduction study & EMG were essentially normal. The tingling improved after a few months, and all that I have now of it is the occasional tingling in the middle, bottom, of my right foot, as described above. I also have some neurological deficits, diagnosed within the past year. These include ocular dysmetria, inability to tandem walk & positive romburg sign. I seem to stumble easily & feel unbalanced often. The neurologist first suspected MS, based on the above and my history of tingling in hands/feet. A brain MRI was negative at the time. Currently he suspects mild, beginning ataxia, as my half brother & half sister on my mothers side BOTH have Spinocerebellar ataxia. They were symptomatic in their 30’s & diagnosed in their early 40’s. They are 20 & 16 years older than me, respectively. Again, I only mention this here as I am wondering if the above neurological symptoms could be related to the condition of my spine. I realize it may seem more like it will be MS or ataxia, but I would still like to know if there is much of a chance that these neuro findings could be related to the condition of my spine instead of being ataxia/MS signs.

THANK YOU in advance for reading this post & offering any input & suggestions you can!!!
Did you find this post helpful?
|

User Profile
replied September 13th, 2007
Active User, very eHealthy
Are you in enough pain to consider LIFESTYLE changes such as eating and exercising habits? What's your current daily schedule look like?
|
Did you find this post helpful?

replied September 13th, 2007
I am in the process of losing weight. It is a slow process, but I actually prefer it that way. I work F/T nights. I am a mom of 3. I am very active. I have tried pilates & yoga. I have balance trouble, and yoga was not as practical Smile Can't afford a personal trainer or one on one instructor, so DVD's is all I had. I do go to a gym as much as I can. Which varies from often to not so often LOL As for eating, so long as it is quick, simple & inexpensive to make, I am in! And I love vegetables!
|
Did you find this post helpful?

User Profile
replied September 13th, 2007
Active User, very eHealthy
Dear OC,

I feel for you. Working F/T nights is no easy gig...with or without kids! Listen, I think that there's not going to be an "magic cure". Often, I believe that pain and discomfort manifest as products of emotional imbalance. I've seen this in my own life. But I can only encourage you to start something and continue it...it seems that you've tried many things, but mastered none. I'd suggest you pick one modality and pursue it to the end. And I am a believer in rhythm. It must be hard to coordinate so many things in your life, but you've got to work on your health regularly. And this is the challenge. Good luck, and let me know if I can help or support you more.

-Yoga

P.S. there are FREE daily downloads of yoga at yogatoday.com ... excellent teachers and varying levels.
|
Did you find this post helpful?

replied September 13th, 2007
Thank you for the kinds words. I understand what you are saying about rhythm. I am not seeking a magic cure. Never have, never would. I know it is a long haul Smile Was just wondering if reaching out online might help me connect with others who have same/similar situations (thoracic pain in specific). Figured there was no harm in trying. Sometimes networking with others is the best way to get an answer.
|
Did you find this post helpful?

User Profile
replied September 14th, 2007
Active User, very eHealthy
Agreed ...
|
Did you find this post helpful?