THORACIC AND ABDOMINAL Sx

///THORACIC AND ABDOMINAL Sx
THORACIC AND ABDOMINAL Sx
Viewing 4 posts - 7 through 10 (of 10 total)
  • Author
    Posts
  • AvatarBillL
    Participant
    Post count: 18

    Dr Corenman:
    Since the last post the updated thoracic MRI returned probably not greatly different than previous study. “Mild dextrooconvex thoracolumber curve.” Also at T5/6 left paracentral disc bulge with mild anterolateral cord deformation, at T6/7 left paracentral protrusion with left cord deformation, at T8/9 small midline protrusion with mild anterior cord deformation,and T10/11 mild broad based left sided disc protrusion with effacement of anterolateral thecal sac without cord deformation.

    Abdominal MRI done per GI doc verbal initial reading by radiologist seems negative with official report due 8/12. Up to date on colonoscopy 1.5 years ago and periodic EGD UTD. Possible faint thigh weakness at times going up stairs but could be imagination. To Further complicate had elevated total CK this past week 365 (upper cut 200 – Age 55), but had also been doing some home exercises and also take rosuvastatin.

    Ortho/spine who ordered thoracic MRI said little other than that the cord was not markedly compressed, that he had never done non traumatic thoracic disc surgeries, that surgery not pursued without severe compression and that’s about it. No plan from here or even sure of exact cause. Didn’t seem very interested overall once MRI resulted. At times feel a momentary sharp pinch sensation LUQ abdomen randomly or with some positional change (plus the original Sx).

    At this point not sure next course of options? GI is going to stay in his specialty area. I would also think that thoracic MRI being done standard supine could possibly underestimate degree of issue vs weight bearing either standing or sitting (although sitting remains the primary issue)? And finally, given Hx of multiple Lumbar discectomies/degen disease can a left lumbar issue including facet produce similar symptoms? Can subtle lumbar instability? Still no leg pain either side.

    Any additional insight appreciated.
    Thanks

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6840

    You can use diagnostic blocks to see if these will give temporary relief. If so, hopefully the steroid injected at the same time will give much longer lasting relief.

    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.
    AvatarBillL
    Participant
    Post count: 18

    As always, thanks for the response. Just as a quick follow-up, presumably at this point this would need to be a pain management consultation? How would they know what level to potentially inject given four or five diseased levels? And would this be in your experience more of a trans foraminal/selective nerve root block or an epidural steroid injection? I know that the anatomy is significantly different in the thoracic area along with increased risks due to presence of the spinal cord as well as mid the Resik location of anterior spinal artery blood supply.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6840

    A good pain management physician is what you need now. The blocks could be SNRBs or ESIs depending upon the need for diagnostic blocks vs. therapeutic blocks. Also, locating the pain with the famous paper clip Xray (putting the paper clip on the focal point of pain and taking an X-ray) can hone down the area of concern.

    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.
Viewing 4 posts - 7 through 10 (of 10 total)

You must be logged in to reply to this topic.