Viewing 2 posts - 1 through 2 (of 2 total)
  • Author
    Posts
  • Rhosier
    Member
    Post count: 1

    My daughter is 15 years old. 3 weeks ago she had acute back pain while washing her hands. No trauma at all to the back. The pain progressed to the point of her being numb and/or tingly from the waist down. 1 bout of urinary incontinence. MRI reveled herniations at L4-L5 and L5-S1. Treated for pain control during hospital admission then sent home with a walker and barely able to stand. A week after coming home, she fell in the bathtub and was readmitted to the hospital. CT of cervical spine states:
    C5-C6 Posterior disc/osteophyte complex and facet osteophytes. There is a paracentral protrusion that measures approximately 2mm with a minimal hyperintense T2 signal, likely representative of an annular fissure. There is mild-moderate canal stenosis with mild flattening of the cord.
    MRI of lumbar spine states:
    Disc space narrowing and dehydration are most significant at L4-L5 and L5-S1. There are facet osteophytes throughout the lumbar spine.
    L4-L5: Posterior dis/osteophyte complex and facet osteophytes. There is a paracentral focal protrusion measuring 6mm in radial dimension with mild canal stenosis. There is slight increased T2 signal likely representative of an annular fissure.
    L5-S1: Posterior disc/osteophyte complex and facet osteophytes result in mild bilateral foraminal stenosis. There is paracentral focal protrusion with increased T2 signal likely representative of annular fissure. This abuts the S1 nerve roots within the lateral recesses.
    The docs that ordered the tests (ER docs), shared the results with a neurosurgeon that recognized the problems but would not treat because of her age. He said that she had the spine of a 60 year old woman. They sent us to a pediatric neurosurgeon who actually said, “there’s nothing wrong with her,” and recommended physical therapy. We went to PT, and they won’t touch her. They feel her issues have not been properly identified and are worried about causing further injury.
    In the meantime, she’s in constant pain. Can you explain the results more clearly for me and offer any suggestions? Currently I’m trying to get a referral to an orthopedist and request a bone scan. What 15 year old has these kinds of issues and yet still goes undiagnosed and untreated? Please help. Oh and for the last week she has intermittent temperature spikes of 100-102. She is also having shoulder pain on one side.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    You daughter has precocious degenerative disc disease-a genetic problem. The collagen fibers of her annulus fibrosis (see website under anatomy) are brittle and some have already torn. These tears can be quite painful and debilitating. I don’t think the tingling in her legs was directly related to any nerve compression.

    This condition requires management in general-not surgery. A good physical examination will help to determine if there is neurological involvement but I suspect not. She will have the propensity to have tears in her discs for the rest of her life and will have to learn good spinal biomechanics and management of these “pain crisis situations”.

    A good physical therapy program is needed, activity modification is necessary and occasional epidural injections can be helpful.

    Dr. Corenman

Viewing 2 posts - 1 through 2 (of 2 total)
  • You must be logged in to reply to this topic.