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Central back ache can originate from a central disc herniation. Discs do not “heal” (there is no blood supply) but the nerve irritation can reduce over time and the disc herniation mass can reduce over time by dehydration.
The CT scan should correlate with the MRI within reason. The CT scan is designed to identify bone but will not identify soft tissue well (discs, nerve roots, cartilage). The MRI will differentiate discs, nerves, tendons and muscles. The MRI however confuses dehydrated disc herniations with bone, tendon and cartilage as all the signals generated by these structures are black.
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.in reply to: spinol injurry #7104I’m sorry to hear about your son. He has had a Brown Sequard injury to his spinal cord. See the website to understand the anatomy of this injury.
Pain in the elbow can be from compression of a nerve root or from neuropathic pain. Nerve compression is obvious from physical examination and imaging studies. Neuropathic pain originates from injury to the nerve itself. If the knife wound caused injury to the portion of the cord and that cord injury is sending pain signals, a different type of treatment is needed.
Neuropathic pain responds to certain medications and spinal cord stimulation but not surgery.
I would be happy to review your MRI. Please call Margaret at the 888 number on the home page and she will arrange for delivery to view the films.
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.If you have already had facet injections in the area of your thoracic pain, you can generally rule them out as a pain generator. If the cervical facets are causing pain, it is possible that they are referring to the mid thoracic spine but less likely.
A cervical epidural should have yielded at least short term relief if the symptoms originated from the nerves of the spinal canal.
The differential is now down to facets in the lower cervical spine, thoracic degenerative disc disease, neuropathic pain syndrome, Scheuermann’s disorder or a rib/vertebral articulation (as long as the ACDF is a solid fusion). Don’t forget that other structures can refer pain to that area (heart and thoracic aorta among others).
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.in reply to: Thoracic back pain #7099Pain in the thoracic spine that has not improved after four months should be looked into. The potential structures that can cause pain are the disc, facet, rib-vertebra junction and the nerve root. There are other structures that are not spine related and although very rare, should be differentially considered such as the heart and aorta.
Whatever the injured structure is, it is unlikely that this will lead to adjacent structure failure. A good workup by a spine surgeon or knowledgeable PM&R doctor will be helpful. You might need an MRI.
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.For those who do not know, a Chiari malformation is a condition where the base of the brain “settles” and a portion of the brain protrudes through the foramen magnum, the large hole at the base of the skull. This crowding of the brainstem causes compression and symptoms that are difficult to live with.
The treatment is to enlarge the hole and decompress the brain stem. This typically involves removal of a portion of the first vertebra and occasional fusion of the upper vertebra.
You apparently did reasonably well after this decompression but note a herniated disc some years after the Chiari decompression.
Your current symptoms could be from foraminal stenosis, a disc hernation, some advancement of the Chiari malformation or cervical stenosis. You do need a new MRI, CT scan and a consult with a spine surgeon who specializes in base of the skull surgery. You can call my 888 number and talk to Margaret for a recommendation of which surgeons might be able to help you (I do not perform Chiari surgery).
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.in reply to: antalgic scoliosis, can it become permanent? #7097A “tilt” (or “list”-better term) from a rotational maneuver is typically associated with an annular tear. This is not a standard finding (most people with annular tears do not develop a list) but is not unusual. These leans (or lists) are associated with individuals with stronger back muscles who can contort their body unconsciously to position themselves away from pain.
The new onset of left buttocks pain that radiates to the left shin is the annulus now fully tearing and the inside of the disc (nucleus) herniating. The extruded fragment from the nucleus is now compressing the nerve root and leg pain results.
What I worry about is motor weakness from the nerve root compression. Try a simple test. Can you walk on your heels and then toes without the foot of the painful leg dropping with each subsequent step? If you are unsure, stand on the painful leg and do 10 quick heel raises or toe raises. If there is weakness or if unclear, you compare good to painful side and there is an appreciable difference, motor weakness is present and you need to present yourself to a spine surgeon without too much further delay.
If no weakness is present (and you don’t feel like you might sprain your ankle or your leg might not hold you up-other signs of weakness), you should at least consider an MRI and an epidural injection to reduce nerve root swelling.
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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