[hrosatelli]

#5814

I am a 54 yr old female. I have cronic lower back pain that goes to my left side down to my foot. I have been told by two doctors I have a compressed disc, I was referd to a neuro sugron with my MRI results and he said all he see’s is a lot of inflamation and no pinched nerve, he said I have an arthric spine. I have my MRI Images. My questions are: What is an arthric spine? and How can an arthric spine cause pain from the lower back to the left hip, buttocks, leg and foot? I am confussed. Thank you for any help that can be given.

[Donald Corenman, MD, DC]

#5816

Take some time to peruse the website. Look at anatomy first to understand what structures are present and what can cause pain. Then look under conditions to see how these structures degenerate and cause pain. I really do not like the term “arthritis” for the spine as arthritis refers to diarthrodial joints and the only joints like this in the spine are the facets. Degenerative or arthritic facets rarely cause pain in the lumbar spine.

The main problem with the lumbar spine is degenerative disc disease. Some individuals have significant degenerative discs and have no pain in their back. Some have incapacitating pain. It depends upon the sensitivity of the individual’s nervous system.

In all cases, if nerve compression develops, buttocks and leg pain will ensue. This is an offshoot of degenerative disc disease as nerve compression cannot occur without degenerative changes.

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.

[hrosatelli]

#5819

This is the report from my xrays back in november of 2011, I could not open the report from MRI disc…..

EXAM: Lumbar Spine 4 Vw Min at 753 hours

FINDINGS:
There is a moderate levoscoliosis of the lumbar spine centered at L3 with Cobb angle measurement of approximately 21 degrees. There is no evidence of acute fracture. There is moderate degenerative disk disease with endplate sclerosis and osteophyte formation at L3-4. The remaining disk spaces are maintained. Oblique views demonstrate normal appearance of the pedicles. Sacroiliac joints are unremarkable.

IMPRESSION:
1. Moderate levoscoliosis centered at the L3 vertebral body.
2. Moderate degenerative disk disease at L3-4.

Signed by Taylor Jordan, MD on 11/29/2011 8:48 AM.

Authored by :
Approved by :
Approval Date : 11-29-2011
Transcription Date:

Now if I only understood what all that means…I do thank you…Helen

[hrosatelli]

#5820

I found on my MRI disc the report, here it is:

; MIV configuration file
;

[General]
Number of Notes=1

[Note#1]
NCDNOTE=9314659
TYPE=Final Report
CREATEDBY=Imagecast
TITLE=Final Report: 01-16-2012 04:20:00 PM, received from Imagecast
HIDDEN=0
HIDEDBY=Imagecast
HIDED=
BODY=Report Dictated By: Blake,Meghan MD||EXAMINATION: MRI LUMBAR SPINE WITHOUT CONTRAST|HISTORY: Chronic back pain radiculopathy.|COMPARISON: None.|TECHNIQUE: Sag T1/T2, Ax T1/T2.|FINDINGS: There is a moderately severe rotary levoscoliosis of the |lumbar spine with apex at L2-3. There is prominent endplate bone |edema and peripherally directed spur rightward along the concave |margin of the curvature and the disc at this level is markedly |degenerated and narrowed. Conus and cauda equina are normal.|Level by level analysis:|L1-2: Minimal bulge.|L2-3: Moderate to moderately severe right-sided foraminal stenosis |from right lateral endplate spurring. Remodeling and edema-like |signal change along the bony endplates suggests active motion segment |instability.|L3-4: There is a 2 mm broad-based protrusion, very mild facet |hypertrophy and mild foraminal narrowing.|L4-5: Thickening of ligamentum flavum and facet capsular tissue with |mild left subarticular and left foraminal narrowing. There is a 1 mm |broad-based protrusion.|L5-S1: Disc is desiccated and significantly narrowed, facets are |overgrown and there is moderate to moderately severe left and |mild-to-moderate right foraminal narrowing, disc desiccation and |height loss with vacuum disc phenomenon and more limited reactive |marrow change than seen at L2-3 here left at midline. There is also |a small annular fissure. Overgrowth of the left facet is associated |with mild capsulitis.|IMPRESSION:|1. There is degenerative change along the concave margin of |scoliosis at L2-3 with disc desiccation, large lateral endplate spurs |and reactive endplate change which suggests motion segment |instability. The right L2-3 neural foramen is stenotic.|2. At L5-S1, there is leftward endplate spur and lesser reactive |marrow change also with significant disc dehydration and height loss |and a moderate-to-moderately severe left foraminal stenosis.|CREATED=01-16-2012 04:20 PM

I have inheratied the scoliosis from my parents, it has never given me any problems before.

[Donald Corenman, MD, DC]

#5826

You have had this scoliosis for many years and the spine is now “wearing out”. The vertebral segments have a “shelf life” of a certain amount of years and the scoliosis wears them out much faster than normal because of asymmetric loading.

The condition of your discs is similar to a car tire mounted on a rim. If the tire is aligned and runs parallel with the road, you could expect 30-50,000 miles out of the tire (as long as you don’t drive like me). A tire knocked out of alignment will wear asymmetrically and wear out after 5,000 miles.

The discs have worn out and are no longer providing shock absorption for the bones of the vertebral bodies. The bones are fracturing due to the increased impact forces “Remodeling and edema-like |signal change along the bony endplates suggests active motion segment |instability.|L3-4:” (per the radiologist).

The abnormal stresses are creating bone spur formation that is narrowing the region the nerves occupy which in turn is causing positional nerve pain “|L5-S1: Disc is desiccated and significantly narrowed, facets are |overgrown and there is moderate to moderately severe left and |mild-to-moderate right foraminal narrowing, disc desiccation and |height loss with vacuum disc phenomenon”.

Unfortunately, these are the typical findings associated with a degenerative scoliosis. You can manage these symptoms with therapy and epidural injections, maybe for some years but more likely than not, you will probably need to have surgical correction.

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.

[hrosatelli]

#5827

Thank you so much for the explaintion, I do appericate it very much. Yes I have been aware of this scoliosis since age 20. I have tried physical therapy with no good results, I have tried Relafen 750MG and it did not help me, I have Tamadol which seems to take the edge off of the pain, my doctor has perscribed for me Celebrex which seems to be helping me, he did mention maybe cortizone shots, but I heard those hurt really bad when injected. We have a hot tube that I use a whole lot, seems to help relaxe my muscles. I do thank you so much.

[Author]

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