cervical disc bulges and ms

Could disc bulges on MRI be similar looking to ms lesions?  The last time I had a MRI on my cervical spine was when I had problems with my left shoulder, arm and neck. I have disc bulges on my c5/6.
If  they are not similar,  Could a lesion be hidden because of the bulge, and could a radiologist or doc. miss it because they are not looking for it?

[COBOB]

Not really.  The disks have a much different density and do not look similar on a T2 sequence.  They are also fixed horizontal structures between the vertebrae.  Lesions look quite a bit different and have a much appearance to the disks when you look at the sagittal and axial views.

Bob

[drsdonthelp]

Thank you.  I haven't had another cervical MRI since 08', I should ask my neuro about getting a follow up one just to re-check. Could having a disc bulge, also cause that L'hermmites thing to happen? It does it every morning when I get up out of bed.

Pamela

[jensequitur]

Quite possibly - all the L'Hermitte's indicates is that there is an 'insult' to the cord at the level of the cervical spine.  It doesn't say what kind of insult is going on.

[drsdonthelp]

Does L'Hermitte's have a pattern as well , like mine lately occurs in the morning.

[COBOB]

It really depends on how the disk bulges.  If the Radiology report says "Impinging on the thecal sac," "displacement of the thecal sac,"  or "intrusion into the thecal space."  Notice the key word is thecal.  This is not a disk bulging outward towards the vertebral processes on the back of the spine, but a disk that has bulged inward "closing off the hole in the doughnut." That is what can compromise the spinal cord.    The  "L'Hermitte's sign" is an indication that that when the thecal space is narrowed by bending your neck forward, that the spinal cord experiences irritation.  When the insult is directly to the spinal cord, like a lesion, a persistent sign or symptom may develop.

Usually if there is a narrowing of the thecal space, the report will talk about "Spinal Stenosis."

Bob

[drsdonthelp]

I am not sure which way the disk bulges.  If it was directly to the spine, what would be considered a persistant sign or symptom?
Sorry for all the questions.
thanks, Pam

[COBOB]

If the bulge is on the anterior side of the cord, there could be motor deficits.  If the bulge is on the posterior, L'Hermitte's sign might be one.  If the bulge is on the left, if could effect sensory and motor on the left at whatever level the bulge is at and below.  Same for the right.  If you have L'Hermitte's sign, that is typically a more posterior lesion or a disk that is impinging on the thecal space.  

Please understand that this is all hypothetical.  If you have a disk issues and associated pain, it really needs to be evaluated by a neurosurgeon.  This is way outside my comfort area, but I don't want to give you a typical MS related answer.  L'Hermitte's sign can be caused by more than just MS lesions.  If you have a blown disk as C5/6 in your neck, neither you nor your doctor should be flexing you neck too aggressively. There are some very nasty things that can happen with just a bit too much force.  I would even be very careful to make sure a massage therapist or chiropractor knew about a blown disk in my neck.

Bob
  

[drsdonthelp]

My bulge discs on c5/c6 were dx in 08.. I have healed since then from the horrible excruciating pain! But, I stil have neck pain from time to time. If I start to feel pain, I take it easy . I am extremely cautious because I never want to feel that again. When they did the MRI, they said I had a bulge disc on c5/c6, a tear in the tendon, and impingement on the nerve.
Could this come back!!! OMG,
As far as the L'Hermitte's sign, I can say that I have felt that before the disc ever went out,
This is definately something I could discuss forever, but I know you have other worries on your mind and I dont want to bore you. Thanks for listening and taking the time out for me.

Pamela

[lori115]

holy cow just reading your posts you are not kidding. we are 2 peas in a pod... bulging discs i have one too and i had no idea these can cause problems. i also have spinal stenosis and bonespurs and osteoarthritis in my neck and a hair line fracture that has healed of course. i go to physio and it is amazing. he does mild stretching in my neck and gentle tissue movement. i also in the last while have been taking fish oils what a difference. doesn't take it away of course but it helps for the imflammation. also for balance and dizziness i have been taking vertigo heel and it helps lots. physio has recommended also a heat wrap for my neck and that is helping. one thing i have learnt with my body this visious cycle has to do with inflamation (inflammation) so as long as we can keep it to a minimal would be better. also i now take 2 baby aspirins a day as i was told that helps for inflammation. big big hugs to you and thinking of you, Lori

[drsdonthelp]

LOL LOL I am actually laughing out loud! Where is your bulge LOL ?? No seriously. Isn't this whole thing crazy!!! OMG,,, I have to have a back and neck rub practically everynight, I have not been dx, with anything like spinal stenosis or bonespurs, but my endocrinologist says that because of my graves disease, I could have osteoarthritis.

Of course i am not laughing at the possibilities of our lives taking such a nose dive, but if you can't laugh it off, it will only bring you down..

Hugs to you my twin... Pamela :)
P.S,, if you want to get a chuckle .. read my Mood "whatever it is" status in my profile.