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Neurology (Expert Forum)
Spinal pain 30 years after Harrington rod surgery for scoliosis and MRI results
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Spinal pain 30 years after Harrington rod surgery for scoliosis and MRI results
by LisaLisa627, Apr 02, 2006 12:00AM
2 months ago - pain radiating down left arm and almost a feeling of my rod broken (it is in the thorac area) and terrible pain in my neck and upper back. Curious as to what MRI results really mean - I am afraid I could end up with revision surgery because I believe that my rod is causing all my problems. 1st MRI done of thoracic and LUmbar - too difficult to read the Thoracic due to the rod. Noted some Modic type 2 degenerative changes involving endplates and marginal spur formation and minor disk bulges on portions they could see. Lumbar - loss of disk height at L5-S and degrees of disk dehydration at L3-L4 and L4-L5. Also, mild disk space narrowing at L4-L5. Broad based disc bulges at L4-L5 and L5-S1 resulting in mild and bilateral nerual foraminal narrowing these assoiciated with facet hypertrophy. Impression reads: Broad based disck bulges at L4-L5 and L5-S1 resulting in mild and bilateral nerual foraminal narrowing.
Two weeks later went back for Cspine MRI - results are: Degrees of loss of disk height and hydration at C3-C4 through C7-T1, most pronounced at C5-C6 and C6-C7. These are associated w/broad based disk bulge and end plate spur formation, which is more pronounced at C5-C6 and C6-C7 resulting in mild and questionable abutment of the cord and mild and bilateral neural foraminal narrowing. Broad based disk bulge at T1-T2 visualized on sagittal view resulting in flattening of thecal sac. Impression: Spondylosis of Cspine most pronounced at C5-C6 & C6-C7, associated w/mild and bilateral neural foraminal narrowing and abutment of cord at C6-C7.
Two weeks later went back for Cspine MRI - results are: Degrees of loss of disk height and hydration at C3-C4 through C7-T1, most pronounced at C5-C6 and C6-C7. These are associated w/broad based disk bulge and end plate spur formation, which is more pronounced at C5-C6 and C6-C7 resulting in mild and questionable abutment of the cord and mild and bilateral neural foraminal narrowing. Broad based disk bulge at T1-T2 visualized on sagittal view resulting in flattening of thecal sac. Impression: Spondylosis of Cspine most pronounced at C5-C6 & C6-C7, associated w/mild and bilateral neural foraminal narrowing and abutment of cord at C6-C7.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Apr 09, 2006 12:00AM
Unfortunately when there is metal in thebody (such as spine instrumentation), the MRI signal in this area is distorted and one cannot tell what is really going on there. There may be less distortion with a CT myelogram, and even less with a conventional xray myelogram - these test involve injection of dye into the spinal fluid surrounding the spinal cord and nerves, then imaging the fluid by CT or xray - any blockages or pinched nerve roots show up well.
Loss of disc height, dehydration, and modic changes are common as we age in the general population. Minor disc bulges may or more usually not cause any symptoms. Spur formation if bad enough can pinch nerve roots in their foramina (holes that they go through) causing pain that radiates down an arm or leg. Abutment or flattening of the thecal sac means that there is less room in the spinal fluid for the spinal cord, but the spinal cord is not necesarily compromised. A plain xray may help show the integrity of the rod inrelation to the surroinding bony stuctures. An EMG study of the arm can sometimes tell if there is any nerve root irriatation from a pinched nerve root.
As I have not seen the actual images this advice is general and may not apply to your specific case.
Good luck
Loss of disc height, dehydration, and modic changes are common as we age in the general population. Minor disc bulges may or more usually not cause any symptoms. Spur formation if bad enough can pinch nerve roots in their foramina (holes that they go through) causing pain that radiates down an arm or leg. Abutment or flattening of the thecal sac means that there is less room in the spinal fluid for the spinal cord, but the spinal cord is not necesarily compromised. A plain xray may help show the integrity of the rod inrelation to the surroinding bony stuctures. An EMG study of the arm can sometimes tell if there is any nerve root irriatation from a pinched nerve root.
As I have not seen the actual images this advice is general and may not apply to your specific case.
Good luck
I had herrington rods installed(thoracic) 27 years ago so it suprised me to read that. I had cervical fusion c-4 to c-7 in 2004.
I'm not a Dr., but the mri sounds like you have some stuff goin on in the neck that will at least need therapy, maybe more. Thats what causes the arm pain most likely. It also can cause upper back/shoulder/neck pain as well.
Do you have any symptoms in the legs or lower back? The lumbar MRI doesnt sound too healthy either, but like I said, Dont take it from me!!!
I had my rods removed a year after surgery.
Hope you feel better soon. Take it easy on your neck, dont look up or down too far if you dont have to. I was told looking up was the worst.
Take it slow...Mike
I have been to specialists and the only thing they can do now is take about 2 and a half centremetres off the top of the rod and fuse the rest of the lumbar spine. My rods start at T4 and end at L3. No guarantee even then of no pain so I have opted not to have that done.
I feel so sorry for you as my life has changed so much. I try so hard to keep a positive attitude and am a member of scoliosis sites on the net to try and help others, but honestly it does get hard. Exercise does not help. nor swimming, nor physio, nor chiropractors, in fact they run if they see me coming.
I probably have made you feel worse but that was not my intention I just want you to know you are not alone in this.
Keep smiling regardless!!
I know now that it is all about pain management now.