[JAO]

#31090

I’d say it’s at the bottom of my thoracic spine. If I had a belly button on my back, the pain would be slightly just below and to the left of it. Hope that helps and thank you.

[Donald Corenman, MD, DC]

#31093

Could be AS but most individuals have + HLA-B27 so could be some other inflammatory arthropathy. Do you have ossification of the spinal ligaments? Have you had an MRI of the lumbar spine and sacroiliac joints?

You pain does sound to be of lumbar origin. The umbilicus is about at the L3 spine level so slightly lower would be the L4 region.

Are you on any immuno-suppression medications?

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.

[JAO]

#31100

Yes, I’m taking immuno-suppressants, Sulfasalazine daily and Cosentyx once monthly.
Yes, the lumbar CT is as follows:

T12-L1 and L1-L2: no canal or foraminal stenosis is seen.

L2-L3: there is a shallow disc bulge but no canal stenosis. Hypertrophic degenerative changesof the left facet are seen. No neural foraminal stenosis is demonstrated.

L3-L4: there is a shallow disc bulge and mild ligamentum flavum thickening but no canal stenosis. Disc bulge, endplate osteophytes, and facet arthropathy contribute to mild bilateral neural foraminal stenosis.

L4-L5: a right hemilaminectomy defect is seen. There is a broad-based disc osteophyte complex which contributes to mild canal stenosis. Disc osteophyte in conjunction with facet arthropathy contributes to moderate to severe right and moderate left neural foraminal stenosis.

L5-S1: there is mild facet arthropathy which contributes to mild bilateral neural foraminal stenosis. No central canal stenosis is seen.

No paravetebral massis visualized. The paravetebral musculature appears within normal limits. Spinal stimulator is seen in the soft tissues.

Impression: Multilevel degenerative changes which are most prominent in the facet joints. Most severe degenerative changes are seen at L4-L5 where mild central canal stenosis, moderate to severe right, and moderate left neural foraminal stenosis are seen.

Do you see anything problematic in the Thoracic MRI I pasted initially?

[Donald Corenman, MD, DC]

#31109

Your lumbar spine has multiple degenerative changes that all could lead to lower back pain or nerve pain; (“Multilevel degenerative changes which are most prominent in the facet joints. Most severe degenerative changes are seen at L4-L5 where mild central canal stenosis, moderate to severe right, and moderate left neural foraminal stenosis are seen”).

There is no indication of findings that would lead to a diagnosis of ankylosing spondylitis (marginal osteophytes or auto-fusions).

Your thoracic spine has changes that also could lead to lower thoracic pain generation (“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… Several small chronic Schmorl’s nodes in the lower thoracic spine”).

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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