Page 1 of 4 1234 LastLast
Results 1 to 10 of 35

Thread: HELP!!! Thoracic Focal Kyphosis, Spinal Stenosis, Bad Discs, Neuro symptoms & more

  1. #1

    Unhappy HELP!!! Thoracic Focal Kyphosis, Spinal Stenosis, Bad Discs, Neuro symptoms & more

    Hi
    I am new to your site, found it through another site while looking for answers or ‘ideas’ at least on the internet. I am not looking for a diagnosis on the net, obviously. But would really appreciate ANY feedback anyone could give me about the symptoms I am having & the state of my spine, and any correlation between them. (MRI & CT Myelogram results are at end of this post if you want to skip to that first!)

    I do not know what tests or type of MD to seek out anymore. Have seen Ortho, Neuro, Urologist, Gynocologist over the last few years. No one has an answer nor do they seem to really care what the cause of the symptoms is, just medicate them. That is just not me or my feelings on how to use medications. (or I could just 'live with the symptoms as is'...or believe everything is just all 'in my head'!! ) But I really would like to know, if at all possible, WHAT is causing these things!! I have lived with it all long enough. (yes, some testing has been done, but seems there should be more than can be done to get an actual diagnosis) Are they all related in some way or different symptoms & different causes? Should I go back to an Orthopedic MD? Could all these symptoms be spine related? Should I continue with or seek out a different Neurologist opinion?

    I know this is a super long post, but I feel that you need as much info as possible to be able to relate to or understand what is going on with me. I know this is a SPINE board, so feel free to only comment on that aspect of the symptoms, but I am giving it all to you incase it helps in any way..or sounds familiar to anyone else. (Especially: Could the condition of my spine & ‘neurological’ symptoms be related. What about the tingling that the Ortho dismissed as not spine related?)

    Any suggestions or ideas on what I should do next or what the cause(s) could be would be GREATLY appreciated. I would at least like to have peace of mind to know that I left no stone unturned! THANK YOU!!!!

    My Info:
    • 40 y/o female. 100 lbs overweight. Fairly active, gym 4x week, square dancing etc. (yes, I am an emotional eater!... but I am as active as I can physically be)
    • No known injury that can be 100% accounted for causing symptoms/back injury. Was in car accident many years ago, but not believed to be the cause.
    • Long standing upper back pain (about the level of my bra strap in the back, and in between my shoulder blades). Most noticeable/bothersome in the last couple years.
    • 10+/- years with an area of decreased sensation (numbness) on the left side of that same area (mid back, left of spine, about shoulder blade level & lower, covering an area about the size of a large mans hand) Seems to be increasing in size recently.
    • Occasional sharp pains in and around the spine in that area, but mainly the pain is an intense ‘ache’ of the upper back region.
    • Pain increases significantly with activity that involves using my arms, such as driving, folding laundry, washing dishes etc. I can barely tolerate anything that requires use of my arms and holding weight combined, such as holding an infant or child, even of newborn weight.
    • Electrical Shocks into & around the urethra area. No cause found by urologist after IVP & exam. First noticed about 2 years ago.
    • Few other long term concerns, like trouble with my memory & such, but highly doubt they would be related to my spine.
    Starting within the last 1 ½ years, I have also noticed...
    (Most of these symptoms...except walking/balance that stays all the time..seem to come & go around same time periods)
    • Numb patches on skin in various areas.
    • Muscle twitching all over my body, many many times a day!
    • Vibrating sensations in my legs & deep in my torso area (also in my spine when I bend my back forward, like to touch toes)
    • Burning/itching areas that often turn out to be numb patches on my skin
    • Balance/Coordination problems. (difficulty tandem walking, sometimes feeling like I may fall when I move but no dizziness ) I have been able to grab onto something a few times & kept from falling that way. Balance is worse in dark or with eyes closed.
    • Difficulty walking at times, as in I feel like I have to force my legs to move. They feel heavy & stiff at times, especially after sitting/laying down. My R & L legs feel different, like one is weaker & that the R legs hits the ground harder that the L & with a thud sound at times.
    • Hands & feet tingling. Comes & goes, as in it may last for a few weeks, go away, then come back again in a few weeks-few months. When the tingling returns, it is in my hands & my feet...it is connected in some way. Not that the hands & feet tingle at the same time literally. But if during a time frame my feet start to tingle, my hands will start tingling also. The tingling is ‘random’ in that it does not just affect one part of the hands/feet. It is all over; maybe a toe & finger, than bottom of foot completely, then 3 toes, palm of hand, one spot on a finger, a spot here & there on my feet etc.
    (I explain the tingling in detail because the Orthopedic MD used this to say that the tingling was not related to my spine based on how it was in hands AND feet at same time & was random in WHERE the tingling occurred in hands/feet, then referred me to a Neurologist)
    • And although this may be ‘way out there’, I would love to know if anyone thinks there could be a connection between ‘whatever is going on with my spine or whatever is wrong with me’ and GI symptoms. I have had 4 ½ years of food regurgitation (spontaneous) that happens most often after I eat a meal. It does not burn. I just feel food coming back up into my throat, sometimes enough that I have to swallow again. Lasts a few hours usually. 2 Upper Endoscopies & no answer for cause yet. GERD meds & diet are of no help.
    TREATMENTS:
    • 2 epidural injections in the T7-8 area, with no pain/symptom relief.
    • TENS unit & a muscle stimulator of some sort that was to relax the back muscles. Neither device offered me any relief, and in fact the TENS unit caused sharp pain where the nerves were being stimulated, even when on low intensity. Unable to tolerate the use of these units.
    • PT Evaluation done (one visit). Was told by therapist there was “nothing they could do” to help me.
    SPECIALISTS SEEN:
    • Orthopedic MD. Over time ordered- MRI’s, CT Myelogram, TENS unit, etc. Final visit he said “No need to come back, I have nothing to offer you”. Suggested pain management in the form of a ‘medication cocktail’ of some sort (pain med, muscle relaxant, anti-inflammatory, antidepressant etc.) The antidepressant would be to help with the side effects of the other medications he said. I chose NOT to go this route!
    • Evaluated by an Orthopedic Surgeon (only MRI’s at that point) who said I was not a surgical candidate. “Thoracic surgery was too major of a surgery unless I was paralyzed.”
    • Referred to Neurologist for hands/feet tingling. He suspected MS. Ordered Brain MRI with contrast, ‘negative’ but did show "There is a small nonspecific focus of abnormal white matter signal in the left frontal region" Had negative EMG & NCS. Normal blood work. No other testing done, no new MRI’s of spine with contrast etc. No explanation for symptoms found. Balance/Coordination problems attributed to ataxia, as I have positive family history. (SCA & FSP diagnosed in my half siblings..or maybe they really had something else, including possible MS. No one knows for sure, no genetic testing done on them)
    • Seen by a Urologist for the above mentioned Electrical Shocks.

    MRI & CT Myleogram results:
    (Myleogram was done about a year after the MRI's)


    MRI CERVICAL SPINE WITHOUT CONTRAST
    TECHNIQUE: T2 sagittal, T1 sagittal, T2* axial, STIR sagittal

    The cerebellar tonsils terminate above the foramen magnum. The spinal cord demonstrates normal signal & caliber throughout it’s visualized course. There is straightening of normal lordotic curvature. The vertebral body heights & alignment is normal. The bone marrow signal is normal throughout.

    C2-3: No disc protrusion. Spinal canal & neural foramina are normal.

    C3-4: There is a small posterior disc osteophyte complex. The spinal canal is mildly narrowed to 8mm. There is mild narrowing of the bilateral neural foramina secondary to uncovertebral osteophtyes, slightly more prominent on the left.

    C4-5: Small broad posterior disc osteophyte complex is present, which narrows the spinal canal to 8mm. There is mild narrowing of the bilateral neural foramina secondary to uncovertebral osteophtyes. Mild right neural foraminal narrowing is present.

    C5-6: Small broad posterior disc osteophyte complex is present, which narrows the spinal canal to 8mm. There is moderate-to-severe left neural foraminal stenosis uncovertebral osteophtyes. Mild right neural foraminal narrowing is present.

    C6-7: Small posterior disc bulge is present. The spinal canal is mildly narrowed to 8mm. There is mild-to-moderate left neural foraminal narrowing. The right neural foramen remain normal caliber.

    C7-T1: Disc, spinal canal, neural foramina are normal.

    The facet joints are unremarkable. Congenitally short pedicles contribute to multiple levels of spinal canal stenosis as described above.

    Impression:
    1) Multiple levels of foraminal stenosis as detailed above.
    2) Multiple levels of mild spinal canal stenosis secondary to small disc osteophyte complexes and congenitally short pedicles as described above.

    MRI THORACIC SPINE WITHOUT CONTRAST
    Technical data: Sagittal T1, sagittal T2, Sagittal STIR, axial T1, and axial T2

    FINDINGS: The vertebral body heights are maintained. No compression deformity is visualized. There is no evidence of bone marrow infiltrating lesion. No edema is visualized on the inversion recovery weighted images. There is a small Schmoral node involving the inferior endplate of T7.

    There is focal kyphosis of the thoracic spine centered at T7-8. At this level, there is a central disc protrusion/disc osteophyte complex measuring approximately 4mm in AP dimension. This causes moderate spinal stenosis with the AP dimension of the spinal canal measuring approximately 5-6 mm. There is no neural foraminal narrowing. The disc does abut the ventral surface of the spinal cord at this level; no abnormal signal intensity of the spinal canal is seen.

    At T6-7, there is a small, 2 mm right paracentral disc protrusion. There is no neural foramen narrowing or spinal canal stenosis. The AP dimension of the spinal canal measures approximately 8mm.

    At T9-10, there is a 1 mm right paracentral disc protrusion without evidence of spinal stenosis or neural foramen narrowing.

    The remainder of the visualized thoracic disc spaces appears unremarkable.

    IMPRESSION:
    Focal kyphosis at T7-8 with a broad-based central disc protrusion causing moderate spinal stenosis at this level. The focal kyphosis causes a kink in the spinal cord best visualized on the sagittal T2 weighted images. No abnormal signal intensity of the spinal cord is present.


    MRI LUMBAR SPINE WITHOUT CONTRAST
    TECHNIQUE: T2 Sgittal, T1 sagittal, T1 axial, T2 axial, and STIR sagittal.

    FINDINGS:
    Conus medullaris terminates normally at L1-2. Nerve roots are normally configured within the thecal sac. There is normal vertebral body height and alignment. The bone marrow signal is normal throughout.

    L5-S1: There is no significant disc protrusion The spinal canal and neural foramina are normal. There is severe hypertrophic degenerative disease of the facet joints bilaterally.

    L4-5: Broad posterior disc protrusion is present measuring 3-4mm. A periphery of abnormal signal intensity represents a small annular fissure. Moderate left foraminal stenosis is seen. There is mild-to-moderate right foraminal stenosis. The spinal canal is narrowed to 7mm. Small amount of CSF is maintained surrounding the nerve roots. There is severe hypertrophic degenerative disease of the bilateral facet joints, which contributes to the spinal canal stenosis. Additionally, there is moderate left lateral recess stenosis and mild right lateral stenosis.

    L3-4: No significant disc protrusion. The neural foramina are of normal caliber. There is mild narrowing of the spinal canal to 8mm with CSF maintained surrounding the nerve roots. Sever bilateral hypertrophic degenerative disc disease of the facet joints is present, which contributes to the spinal canal stenosis.

    L2-3: Disc, spinal canal, neural foramina are normal. There is severe facet arthropathy.

    L1-2: Disc, spinal canal, neural foramina are normal. There is severe facet arthropathy.

    T12-L1: Minimal disc bulge is present. The spinal canal and neural foramina are normal.

    IMPRESSION:
    1) Mild degenerative disc disease, most pronounced at L4-5 with protrusion and annular fissure.

    2) Bilateral neural foraminal narrowing and lateral recess stenosis at L4-5.

    3) Mild spinal canal stenosis at L3-4 and L4-5

    4) Severe facet arthopathy throughout the lumbar spine.

    From a CT Myelogram that I had late last year, I have the following info available. I do not have the full report on hand that would say how it was done etc. I had only typed up this info as a comparison with the Thoracic MRI:

    At T6-7: 2 mm right paracentral disc protrusion creates a mild impression on the right ventral cord. However, overall the spinal canal remains of adequate caliber. There is no associated foraminal stenosis.

    T7-8 A central disc/osteophyte complex measures 4 mm in AP dimension resulting in a flattening of the ventral cord with reduction of caliber of approximately 20%. The spinal cord measures approximately 4 mm in AP dimension. A small rim of contrast remains surrounding the dorsal cord. The spinal canal measures 5 mm AP. The neural foramina remain normally patent.

    T9-10: There is a 1-2 mm right paracentral disc protrusion resulting in a minimal flattening of the right cord. No significant central or foraminal stenosis is present.

    The remaining disc levels demonstrate no evidence of significant disc protrusion or foraminal or central stenosis.

  2. #2
    Sorry..I am back already with another question :-)

    The Spine MRI's that were ordered by the ortho were without contrast and ordered for 'back pain' specificaly. When I asked the neurologist if this was sufficient to see other degenerative conditions, especially lesions in MS, he said yes. He did not want to order new MRI's, even after a year (year & a half maybe) had past from the first MRI's. Does anyone know if this is accurate or the general rule of thumb? Or would Spine MRI's with contrast ordered for 'degernative' conditions possibly be done & read differently?
    He did not look at the Spine MRI's, just read the reports. (Not sure about Brain..can't remember if he looked at it or just read the report)

    Although his first thought was MS, at my last visit to him he said that my "clinical symtoms would be worse if I had MS" Not sure what he meant by that though. Either way, he does not seem to want to do any more testing, except a DNA test for Ataxia, that the Ins. probably wont cover (and at THOUSANDS of dollars in cost, It won't be done unless it is paid for by Ins!)


    Thanks again for the feedback...

  3. #3
    Senior Member lynnifer's Avatar
    Join Date
    Aug 2002
    Location
    Windsor ON Canada
    Posts
    16,228
    Hi SeekingAnswers ..

    I have no idea how to comment on your post whatsoever so I'm going to ask Dr Young to comment.

    I'm paralyzed from the waist down, myself, from Transverse Myelitis, for 23 years. Did you notice a difference in symptoms with weight loss or gain? One would think you'd 'fit the statistics' for MS.

    Regardless, I wish you luck with your search for answers!
    http://en.wikipedia.org/wiki/M%C3%BC...en_by_Internet

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  4. #4
    I am surprised by your discussions with the doctors. To me, what you describe seems pretty straightforward. Most of your symptoms can be attributed to a thoracic spinal cord problem. The MRI shows a definite kyphosis with 20% compression of your spinal cord. That is consistent with your symptoms. So, I don't understand the disseminations concerning multiple sclerosis and other issues. What did the doctors say about the thoracic spinal problem and what can be done?

    Wise.

  5. #5

    Basically..nothing! That is what the Ortho said.

    Dr.Wise,

    RE: "What did the doctors say about the thoracic spinal problem and what can be done?"

    Basically..nothing! That is just it! This is why I feel like I have to try & get answers on my own. I do not know who to turn to anymore (what TYPE of MD).

    The first Ortho MD I saw did Xrays only. (this was about 3 years ago) He looked at my Xrays & said "There is NOTHING wrong with your back except arthritis. Lose weight. You'll be fine" He REFUSED, literally, to do any more testing. Not even an MRI. Fast forward about 1 1/2 years. Still in pain, etc so I ask to see another Ortho. This MD did MRI's. Eventually I ended up having the full 'set' of MRI's. He said "well, there is definately something wrong with your back. I can't believe the other Ortho said nothing was wrong" And yet, he offers me no solution, (well, pain meds) except he said see an Ortho surgeon. So, Off I went to the Ortho Surgeon who said "Thoracic back surgery is MAJOR. It involves removing a rib, goes through the chest & so on. It can do more harm than good. Your situation does NOT warrant surgery, UNLESS you become paralized. And although that is a possiblity, it is not likely". So, of course that scared me (I would truly be terrified of the possible consequences!)..so I did ot persue any more surgery type optoins. Add to it I REALLY DO NOT WANT surgery! But I also don't want to let things get so bad, that there is no hope. I am ONLY 40!! And I suffer a lot! And IF all these symptoms are related to my spine, then there is no doubt I am getting WORSE! So, If surgery is the answer, so be it. I just want to know WHAT is wrong with my back, WHY I am having ALL these symptoms & IF they are ALL related and, what if anything can be done to stop the damage & get me back to being pain & symptom free. Before it is too late!

    Ok, back to the answer: So after a couple more visits to the Ortho MD, and still no answers, I (YES, I) asked for a CT Myleogram because I had read somewhere it was a better test in some way for the type of Thoracic pain I was having. He was hesitant but agreed. When he read the CT Myelogram he said "well, it says the same thing the MRI did" That is when he suggested the 'medication cocktail' and said that if I went to enough doctors, someone would offer me surgery, but he did not suggest I let anyone do surgey on me.(yet a year before he himself sent me to an Ortho Surgeon) He also said "don't waste your time coming back to me, not that I don't want to see you, but I have nothing else to offer you."

    Fast forward another 6 months. And here I am! Neuro said "maybe MS, did Brain MRI & said no MS" But does not have any other answer & is not interested in doing any more tests. Ortho says Neuro symptoms are NOT related to my spine (just the back pain is related to my back). Ortho Surgeon says "No Surgery" And I am left scratching my head & trying to figure it all out on my own!!!!!!!!!!

    So maybe I can revamp/simplify my questions to you:
    1) Should, in your opinion, I seek out another Orthopedic MD? Just based on what you said already, I think the answer will be yes.
    2)If so, WHAT type of Ortho should I see? Regular Ortho? A surgeon? Someone specializing in spine injuries? (is there such a practice)
    3) The ortho I saw said the tingling in hands & feet COULD NOT be from the spine based on the location & nature of the tingling. You seem to disagree with this. So, could it be, and if yes, is it the T7-T8 that is probably causing it?
    4)And could any GI symptoms I mentioned in first post be related to the spine? It would be VERY interesting & helpful if teh answer is yes!

    PLEASE offer me any suggestions you can think of. I do not know what else to do, who else to see. I am on an HMO Ins, so am somewhat limited in choices, but I do whatever it takes. I have to get someone to pay attention to me, but I don't want to waste my or their time if. If it is neuro, I will go that route. If it is Ortho, then I will go that way, know what I mean?

    THANKS AGAIN. Sorry for the long post.

  6. #6

    To Lynnifer...

    Lynnifer:
    RE: "Did you notice a difference in symptoms with weight loss or gain? One would think you'd 'fit the statistics' for MS."

    I do seem to fit the statistics, and the symptoms even seem to fit to some extent. BUT, if they can be explained as being related to my spine, I need to get a solid answer on that!! I hate to continue to think it is some neuro degenerative disease if it is really my spine! ANd I can't get treatment until I get a solid answer/diagnosis.

    I have always been overweight to some extent. My weight has been 'stable' for years. I don't gain or lose, basically. So, I can't really attribute changes to weight fluctuations.

    BUT, I can say that one thing that keeps coming up in my mind, is that the symptoms seem to worsen when I am most active. Not just the pain. The tingling started a while back, then the electrical shocks. BUT, I started going to the gym 4x a week this year (Jan.) and have been very consistent in going. And now that I think back, that seems to be when I also noticed a SHARP increase in all the other symptoms, and new symptoms starting, like the buzzing senstaions. And, after a 3 month break in Square Dancing, I started again in ...JANUARY! Hmmm. Maybe there is a connection. If so, Then seems like even more of a chnace it is my back causing all these symptoms, and dang it! Someone needs to fix it before I end up disabled! UGH!!!

    It does not help that whenever I try to get info on "thoracic" injuries/conditions of any sort, all I seem to end up with is generic info like "Thoracic injuries are rare due to the rib cage minimizing motion"... Then it goes on to talk about lumber & cervical info. More UGH! SO, if anyone has any good links on THORACIC info, I would really appreciate it! I may have something going on with the Cervical & Lumbar spine (based on the MRI's), but I THINK the symptoms are PROBABLY related to Thoracic spine, IF they are related to the spine at all.

  7. #7

    Smile

    By the way...Square Dancing is very demanding on one's spine! It takes a TON of twisting & turning, you are in motion almost constantly for brief periods at a time. It requires constant use of my arms. Requires fast walking & quick movement. Honestly, it is probably NOT what I should be doing..but I LOVE it! It is SO challenging to me. Mentally & physically. (Google square dancing videos or look on 'You Tube' if any one is curious)

    Looks like I will be having surgery for severe achilles tendenosis soon, and I am not looking forward to not being able to Square Dance for 8 weeks! But, I guess if my other symptoms improve (tingling & such) I could speculate even more that the activities I am doing is not good on my back! LOL

    We'll see...I still want a solid answer once & for all!

  8. #8
    Super Moderator Sue Pendleton's Avatar
    Join Date
    Jul 2001
    Location
    Wisconsin USA
    Posts
    10,826
    OK, I hate this but could you give us a general area where you live so we can possibly recommend a doc in your area? And, it's ridiculous but unless you're in the business my experience has been that many docs dismiss patients who can speak "doc talk" as either a future litigant or someone who spends too much time online diagnosing themselves. Try to ask a few questions that require you to ask for simple answers in layman's terms can do wonders to a docs attitude.

    Personally, I'd take Wise's answer, the question that the anwer addressed and skip all the other [as you say "the long stuff"] and find a good orthopedic surgeon. If you bring up all the other stuff an orthopod will send you to a neurosurgeon. The neuro will read everything and send you back to the orthopedic surgeon. IOW, start with bowing left and right and leave the reels and alamands out for now (yea, as a teenager).
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  9. #9
    Sue, I live in Orange County, CA. I have HMO insurance & my medical group is in the city of Orange.

    As for the rest of your response, not sure I really understand..but in general I can say I do not talk in such a way to imply I know more than the doctors. I only researched the net out of frustration. When I saw the Ortho docs I only took my reports, I did not take all the info & questions I posed above. I only posted that here in hopes it might help someone offer me suggestions as to what to do, who to see next, and if these symptoms seem connected.

    If nothing else comes of my post here, so be it. At a minimum Dr.Wise's first response malkes me think there might be a connection between the spine condition & the Neuro symptoms. (Remember, I was told there could NOT be a connection!) So, that makes me feel at least a little more like trying to continue to find a good Ortho (Neuro?) to get a 2nd opinion from.

    Thanks for offering to help...

  10. #10
    Super Moderator Sue Pendleton's Avatar
    Join Date
    Jul 2001
    Location
    Wisconsin USA
    Posts
    10,826
    Let me do some digging this weekend. No problem with researching your problems but some docs get a bit grumpy if you don't do the awe thing.. I guess when you spend that much money and time to be aoc you deserve respect but awe, well, LOL. I'd say either an ortho or neuro would be a good surgeon for decompression as long as they have experience in it. Hopefully decompression will solve the neuro problems.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

Similar Threads

  1. Replies: 7
    Last Post: 08-29-2012, 01:08 AM
  2. Replies: 17
    Last Post: 05-28-2011, 10:03 AM
  3. Replies: 5
    Last Post: 01-24-2006, 04:52 AM
  4. Replies: 3
    Last Post: 03-11-2005, 11:16 PM
  5. Replies: 0
    Last Post: 07-29-2002, 01:16 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •