Oh my achin’ Thoracic Spine

///Oh my achin’ Thoracic Spine
Oh my achin’ Thoracic Spine
Viewing 6 posts - 1 through 6 (of 10 total)
  • Author
    Posts
  • AvatarJAO
    Participant
    Post count: 6

    I’m 56 and have been dealing with chronic back pain for many years. I’m under the care of a rheumatologist and her working diagnosis is Ankylosing Spondylitis, but I also suffer from mechanical back pain and genetic degenerative disc disease. Four years ago I had a decompression surgery at T11-12 for central canal stenosis and a discectomy for a herniation at L4/5. A few months later I had new pain. A new MRI showed a new huge herniation at L4/5 and I had another discectomy. After that recovery, I continued to have pain and was chasing the pain via RFA and facet injections. I had to stop working as sitting all day combined with the pain from the AS and the mechanical back pain made working impossible. Finally, I was offered a SCS. I had a successful trial and for several months after the final surgery (done 12/2017) I experienced a honeymoon phase when I truly was doing better. I was able to cut my pain meds in half and was feeling very hopeful. Then about a year ago this insidious pain started, I describe it like a toothache in my back that just never goes away. After trying multiple procedures (RFA & facet injections) done by my pain Dr. the pain will not relent. Here is my recent MRI. I’ve not seen my neurosurgeon to follow up on the MRI results. The idea of yet another back surgery overwhelms me. I’m curious if these results would warrant treatment or are just an indication of further degeneration I’ll be living with. Thanks so much.

    Impression

    Interval placement of a spinal stimulator at T7-T8.

    Stable lower thoracic degenerative changes resulting in multilevel neural foramen stenosis and mild to moderate spinal canal stenosis at T10-T11.

    Status post T11 laminectomy, with focal kyphosis and degenerative endplate marrow edema at T11-T12.

    Released By: KEIRSUN CROCKETT, MD 8/29/2019 12:00 PM
    Narrative
    EXAM: MRI THORACIC SPINE WITHOUT IV CONTRAST

    CLINICAL INDICATION: M96.1 (Postlaminectomy syndrome, not elsewhere classified)

    TECHNIQUE: Multiplanar, multisequence MR imaging of the thoracic spine without IV contrast.

    COMPARISON: 7/10/2017.

    FINDINGS: Interval partial resection of the T7 and T8 spinous processes and insertion of a spinal stimulator at T8-T9 via an interspinous approach. The stimulator leads are positioned at T7-T8 in the dorsal spinal canal, presumably in the epidural space
    though magnetic susceptibility artifact from the hardware prevents definitive evaluation.

    Status post T11 laminectomy. Focal kyphosis at T11-T12, with height loss of the T11-T12 intervertebral disc, mild chronic T11 and T12 vertebral body wedging, and degenerative endplate marrow edema. This results in focal kinking of the spinal cord at
    T11-T12. Otherwise normal thoracic spinal alignment. Otherwise normal vertebral body heights. Several small chronic Schmorl’s nodes in the lower thoracic spine.

    Degenerative changes predominantly at T10-T11 with bilateral facet arthrosis and ligamentum flavum thickening resulting in mild to moderate spinal canal stenosis. No other levels of significant spinal canal stenosis. Multilevel mild facet arthrosis in
    the lower thoracic spine, resulting in multilevel mild to moderate neural foramen stenosis.

    Normal size and signal intensity of the thoracic spinal cord.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6907

    Where is this toothache pain located? is it in the thoracic or lumbar spine? Please describe how the pain is aggravated. Is it increased with load, time of day or position?

    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.
    AvatarJAO
    Participant
    Post count: 6

    The toothache type pain is almost as high up as my waist height. At times there is a spot to the left of the spinous process that is very tender if you push on it. In July I had some facet joint injections in L2/3, L3/4, L4/5 because I have DDD and a bulging disc in my lumbar too. That pain Doc said, “Judy, if this doesn’t really help your pain, we need imaging of your thoracic spine.” Standing and sitting aggravates this pain. But there are many nights when I’m laying in bed and my back just hurts and hurts. I have pain at times in my left groin, hip, and front of thigh. I’ve also started having pain on the outside of both calves. That particular calf pain is new for me. Overall, the leg pain is more of an inconvenience. The pain in my back is debilitating. I am working on a disability claim with the SSA and had an FCE done last winter. I know I’m limited, but it was difficult to read the long list of all the things the medical professional said I can’t do in a sustained effort. Can’t sit or stand more than 15-20 minutes. Can’t walk a city block. Can’t lift xx pounds to chest height, or over my head, etc. My world has become very small and the couch and my ice packs are my new best friends.

    • This reply was modified 6 days ago by Avatar JAO.
    AvatarJAO
    Participant
    Post count: 6

    Most days I wake up feeling very stiff in general, not just in my back. This particular toothache pain is aggravated with most all upright activities, not so much based on time of the day. Although, the pain often keeps me awake at night…. like right now even though I took all the pain meds I’m allowed, my back is just killing me.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6907

    If you could better describe the location of your most severe “toothache” pain, that would be helpful (right/left, central or off midline, right above the pelvis or at lowest rib level, buttocks). Ankylosing spondylitis could be causing your stiffness. Did you test positive for HLA-B27? Do you have high CRP and ESR labs?

    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.
    AvatarJAO
    Participant
    Post count: 6

    The pain is just left of what I would call my spine. So it’s not far left, like the flank pain I had when I had a kidney infection once. It’s close to my spine, but to the left of it. I’m sure the stiffness and the SI joint pain I struggle with at times is from the AS. I typically get bi-lateral SI joint injections twice a year and they do help. I was negative for HLA-B, but do have elevated CRP. Last test done in August was 37, and it’s been as high as 49. Last ESR done April was the highest at 28. I have pain in peripheral joints as well as axial. Right now my elbows are really flaring.

Viewing 6 posts - 1 through 6 (of 10 total)

You must be logged in to reply to this topic.