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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Disc prolapse in cervical and lumbar spine. Getting headaches, blurred vision and vomiting. Concerned

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Dr. Rahul D Chaudhari

Spine Surgeon

Practicing since :2002

Answered : 322 Questions

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Posted on Wed, 16 Jan 2013 in Back Pain
Question: Had epidural injections about 6 weeks ago them a discogram about 4 weeks later. I have heations inC5-6-7 also have rupture at L-3-4 wth fissures L-2-3 WAS the pain generating disc at discogram. Also have DDD. I jad L5S1 fused in April And spinal stenosis I'm there somewhere in the mix
I am awaiting a referral to Stanford. This last weds I started getting severe frontal left sided headaches with blurred double vision and vomiting. I feel ok in the morning but by early afternoon it all sets in. My mother thinks I should call ambulance but I think it can wait until Wednesday after holiday
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Answered by Dr. Rahul D Chaudhari 3 hours later
Hi,
Thanks for writing to us.
You have disc prolapse in cervical and lumbar spine which can cause neck and back pain. Your current symptoms may be due to one of the following reasons.
a. Headache due to spinal leak is usually postural and get worsens in upright position and it relieves in lying down position.
b. Your current medication includes orthocyclene which may causes nausea and vomiting.
c. Also metformin sometimes causes hypoglycemia if your diet is not proper which can lead to headache and dizziness like symptoms.
These things could contribute alone or together to cause your symptoms.
Let me know if you have any more concerns.
Above answer was peer-reviewed by : Dr. Aparna Kohli
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MRI OF LUMBOSACRAL SPINE: -

PROTOCOL:

-     SE T1W & TSE T2W SEQUENCES IN SAGITTAL PLANE.
-     TSE T2 W SEQUENCE IN AXIAL PLANE.
-     STIR SEQUENCE IN CORONAL PLANE.
-     MR MYELOGRAPHY USING HEAVILY T2W SEQUENCE IN SAGITTAL AND CORONAL PLANES ON A 1.5 TESLA SCANNER.

There is some degree of straightening of lumbar lordotic curvature. Vertebrae are normal in height, alignment and marrow signal intensity.
Dessicative disc changes and anterior osteophytes are noted at multiple levels. Disc height is reduced at L4-5 with degenerative endplate changes at this level.

There is diffuse disc bulge, thickened ligamentum flavum & facet joint arthropathy at L4-5 compressing the thecal sac and causing spinal canal stenosis with bilateral neural canal compromise (L>R). The mid sagittal diameter and area of spinal canal are 0.8cm and 0.75cm² (lower normal limits are 1.0cm and 1.5cm² respectively. Effusion is detected in the facet joints.
Annular tear, diffuse disc bulge and facet joint arthropathy are visualized at L3-4 indenting the thecal sac.
Diffuse disc bulge is observed at L5-S1 mildly compromising the neural canals bilaterally.

Cord ends at L1 vertebral level and shows normal signal intensity. No abnormal pre or paraspinal soft tissue mass is seen. MR myelography confirms the above findings.

Impression      :     MR findings reveal lumbar spondylotic changes with
     -     Diffuse disc bulge, thickened ligamentum flavum and facet joint arthropathy at L4-5 compressing the thecal sac and causing spinal canal stenosis with bilateral neural canal compromise (L>R).
     -     Annular tear, diffuse disc bulge and facet joint arthropathy at L3-4 indenting the thecal sac.
     -     Diffuse disc bulge at L5-S1 mildly compromising the neural canals bilaterally.

-     To be correlated clinically.

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