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I do think the radiologist is describing Schmorl’s nodes at T10 and T12. Do not be concerned about future herniations. Just find your limitations regarding the current herniation and do your best.
Hemangiomas are usually normal areas of the bone that have an excess of blood vessels. These normally mean nothing. They can be confused with fat excess in the bone which also normally means nothing.
As long as you are improving, you need no further MRIs.
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: 3 Unsuccesfull Microdiscectomies, Whats next? #4943I assume you have had recurring disc herniations at L5-S1 and have had three surgeries. Yet another herniation has occurred that is compressing the nerve root. The typical surgical planning that occurs after the third herniation is a TLIF fusion performed on this level but there are exceptions to the rule. This TLIF fusion prevents recurring herniations and further damage to the nerve root.
The TLIF ablates the disc space, and allows plenty of room to decompress the nerve root which is most likely scarred down after three surgeries. The fusion of L5-S1 will probably not be noticeable to you in function after healing as there is most likely no disc material left in the disc space and the motion of this space is currently negligible.
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: Foot and leg pain #4940Sitting pain that improves with standing and walking is normally related to a herniated disc but your films look reasonably good. You have some small tears and minimal bulges but all in all with the smaller images I have seen, there is no obvious compression of a nerve root. The possibility of a peroneal nerve injury is possible. This nerve is exposed at the lateral aspect of the knee and if compressed, can cause these symptoms.
Ask your doctor if you would be a candidate for a conduction nerve test of the involved leg (EMG/NCV).
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.Your Schmorl’s nodes go along with soft endplates when you were young. This can be a form of Scheuermann’s disorder associated with degenerative disc disease in the thoracic spine which has a higher chance of herniation. Classic Scheuermann’s has wedging of vertebra and deformity but there is a variant that only has endplate changes without deformity. It is what it is- so don’t think too long and hard about it.
I still think at your point that epidurals can be effective. The success rate is not 100% but I believe relief can be gained in about 60-70% of patients. The question is how long the relief may last. It may be 3 weeks or 9 months. The pain level may drop by some percentage also permanently.
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: Foot and leg pain #4935You report 5 months of foot and leg pain associated with buttocks pain. Without the buttocks pain, the differential would have to include entrapment of the common peroneal nerve at the knee but with buttock pain, the source is most likely the lumbar spine.
Is your pain worse with standing and walking or with sitting? What activities make it worse and better?
The MRI report appears incomplete. I generally have trouble with word modifiers such as “mild” as I am forced to view the MRI through the radiologist’s eyes. I have had previous patients place their MRI images on flick’r. This does allow others to view your images if you are OK with that.
Reactive depression is typical with chronic pain.
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.You are very intuitive. You make a great point that the scar that covers the annular tear is not as strong as the original collagen tissue that had torn. You are also correct that the pressure drop in the nucleus reduces the stress on the torn annulus.
Interesting that there are no case reports of recurrent thoracic disc herniations that I know of in the literature. There would be no recurrent hernations after surgery as surgery is designed to remove the herniation and fuse the level. The recurrence rate for lumbar disc hernations in an active population is about 10%.
A sequestered fragment (one not attached to the tear of the disc) can migrate but normally will migrate out of the canal and usually not cause further problems.
The chance of another disc herniation is limited. If you have Scheuermann’s disease (see website), you do have a higher chance of a herniation at another site, but still that chance is small. The positions of yoga you have sent by itself should not cause a herniation. However, if you already had a complete tear and load the disc in that manner, the herniation could occur.
There are some spine surgeons that think “If I have a hammer, the world looks like a nail” and everything is a surgical answer. I would like to think these individuals are rare. The surgeon should be the best person to determine if surgery is right for you. Many spine surgeons are also great diagnosticians and will discuss with you your options and should not push surgery unless it really is indicated or you are well informed of your options.
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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