[Missie]

#32655

MRI scan from two years ago below (post surgery MRI 10 years ago -reported just left sided deformity of spinal cord from t7/8 discs and some stenosis and nothing else) so quite a bit of change.

Progressively worse walking gait.

Chronic discovertebral changes at t7-8 level with destruction of the endplate contours predominantly anteriorly and the related intervertebral disc with significant sclerosis and relativley minor marrow odema in the rest of the veterbral bodies. A central disc herniation/soft tissue thickening/bone fragments are seen indenting the theca with flattening of the cord anteriorly at this level. There is also no evidence altered signal from the cord at this level. There is also no evidence of a syrinx above and below this level. Facet joint degeneration change is also seen at this level and the level above.There is no evidence of foraminal encroachment on the exiting nerve roots although some soft tissue thicking is seen around the exiting left sided nerve root at t7-8 level. However in addition the headof the left sided rib at the t7-8level is not clearly seen while the right appears normal. some soft tissue thickening/bone fagments is also noted here outside the left sided neural foramen probly related to the left costo transverse joint at this level which is also involved. there could be a chronic osteoarticular destruction here related to the costovertebral costo/transverse joints and allied with the t7-8 discovertebral changes, the appearences could be those of a chronic progressive neuropathic state in this level of the spine. a ct is recommended. There is an old superior endplate fracture involving the T2/3 levels. No other significant abnormality is seen in the cervical or lumbar spine. The rest of the cord appears normal.

90mg Baclofen doesn’t touch severe spasticity after 9 years on it. And all other meds stopped helping too. So I cope with nothing. Except the trigger point injections your suggested :-)

I’m over joyed to know there could be some help with Botox or other procedures. I’ll ask my Dr to refer me to a specialist as you recommended. Just the hope for now or future has helped me tremendously. If it isn’t an option then I feel less scared as I understand more. Thank you so much for your time. I’ll keep you updated Dr :-)

[Donald Corenman, MD, DC]

#32674

You still have some cord compression as noted by the radiologist; “A central disc herniation/soft tissue thickening/bone fragments are seen indenting the theca with flattening of the cord anteriorly at this level. There is also no evidence altered signal from the cord at this level”.

It is difficult to fully understand how significant the cord compression is as “flattening of the cord” is cord distortion but might not be significant enough to cause your current symptoms. He or she does not mention any canal stenosis (narrowing) which would be important to note.

Please let us know how you progress with the Botox treatment.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[Donald Corenman, MD, DC]

#32675

You still have some cord compression as noted by the radiologist; “A central disc herniation/soft tissue thickening/bone fragments are seen indenting the theca with flattening of the cord anteriorly at this level. There is also no evidence altered signal from the cord at this level”.

It is difficult to fully understand how significant the cord compression is as “flattening of the cord” is cord distortion but might not be significant enough to cause your current symptoms. He or she does not mention any canal stenosis (narrowing) which would be important to note.

Please let us know how you progress with the Botox treatment.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[Missie]

#32683

Thank you Dr
I’ve been under the spinal cord injury consultants for ten years now.
I was diagnosed t6 incomplete browns sequard syndrome. Back then my MRI said I had disc prolapses at t7/8 and
Stenosis and deformity of the spinal cord on the left side. Then 2 years ago this cane on my scan. As you say there is no mention of stenosis. It’s very confusing for me. That’s good to know though if I not have stenosis. I’ll talk to my consultant about this too.

Over here in the UK. The consultants are wonderful. Yet they say little is known about thoracic spine. So I have had minimal help.

My spasticity is very severe (legs move either very fast and little or so violent they throw me off chair/bed) urodynamics confirm neuropathic bladder (want me to gave a caterer but I say no) and I have neuropathic bowel too (spastic reflex).
In addition I have autonomic dysreflexia and postural hypotension too and that’s tricky to handle yet I cope.

I’ve had a brain scan as I fell and hit my head hard on concrete and a car. This was normal ????.

[Missie]

#32684

Hi Dr

P.s. Surgery was originally an emergency 2 years post accident. Bladder bowels legs no sensation and couldn’t feel/move legs.

Scans remained unchanged after surgery as they were pre surgery regarding the discs. So they classed this as failed surgery. That I’d had spinal shock and I’d somehow got moblity back a bit but not much. The spasticity didn’t start until after surgery.

The theca flattening – unsure when this occured (showed up on the scan two years ago). Yet I’ve had many falls and didn’t go hospital with deterioration from these ???? after my last scan and this one.

[Donald Corenman, MD, DC]

#32689

I would call the radiologist and ask if there was central narrowing (in his or her opinion) and if there was anything that could be considered now to possibly open the canal (if needed).

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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