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Suggest Treatment For Herniated Discs In Thoracic Spine
Question: I herniated 2 discs in thoracic spine, T10-T11, T-11-t12 (it was quite bad legs went numb, tingling up to top of undergarments, burning wrapped around my chest, couldn't urinate for over 1 day--initial EMG/NCS showed l5-S1 radiulopathy (they did lumbar mri as well which didn't correlate to EMG/NCS & found nothing significant in lumbar MRI) 2nd EMG/NCS was normal as well as SSEP, but left with continued numbness, all around my legs, and up to my briefs, which can now be quite painful, especially at night, both legs are quite heavy I can't really lift them more than an inch or two. Walking is a challenge and my legs feel quite weak. I continue to have burning that radiates from just under my left breast, across my middle back, to just under my right breast. I am in physical therapy for a 2nd time for "gait disorder." Another MRI of thoracic and lumbar with and without contrast (to reevaluate herniated thoracic disc) shows a diameter of the spinal canal at t10-t11 of 8 mm with no CSF between disc and cord, t11-12 show 9mm diameter. Mild neural bilateral neural foramina narrowing at t10 11. Lumbar showed nothing significant. Although I have read it is rare, I think that my continued leg problems are due to thoracic spinal stenosis. Your thoughts and recommendations.
Brief Answer:
You may need surgical decompression.
Detailed Answer:
Hi
Thanks for your query
I'm Dr Sudhir Kumar
I have gone through your query and understand your concern. Thoracic disc herniations are quite rare. But in two MRI shows your disc herniations atT10-T11 and T11 and T12 and your symptoms correlate with spinal stenosis then probably diagnosis is correct. You are already on physiotherapy. I think if you have no relief by physical therapy and rest then it is better to surgical decompression of spinal stenosis by surgery. Till then you can take analgesic such as ibuprofen for pain relief. Nuerotropic agents such as Mecobalamine are helpful. You can discuss with your doctor about it.
Hope your query get answered. If you have any clarification then I will be happy to help you.
Wishing you a good health.
Take care.
You may need surgical decompression.
Detailed Answer:
Hi
Thanks for your query
I'm Dr Sudhir Kumar
I have gone through your query and understand your concern. Thoracic disc herniations are quite rare. But in two MRI shows your disc herniations atT10-T11 and T11 and T12 and your symptoms correlate with spinal stenosis then probably diagnosis is correct. You are already on physiotherapy. I think if you have no relief by physical therapy and rest then it is better to surgical decompression of spinal stenosis by surgery. Till then you can take analgesic such as ibuprofen for pain relief. Nuerotropic agents such as Mecobalamine are helpful. You can discuss with your doctor about it.
Hope your query get answered. If you have any clarification then I will be happy to help you.
Wishing you a good health.
Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
Dr. XXXXXXX
Thank you for your reply. I am under therapy for a 2nd time for "gait disturbance." My ability to move is significantly impacted. My more recent EMG/NCS was normal so was the study to check for cord pressure, an SSEP.
1, Since the imaging provided the measurements of the diameter of the canal at those areas and my leg problems (movement and pain) continue, is that not enough information to establish spinal stenosis?
2. Must the nerve studies be positive first (the initial one was and they found nothing in the imaging for low back origin nor do I have/have never had low back pain)? I can barely get around (movement problem and bad leg pain) and wonder if I will be left in this condition at 46 years of age. I am basically housebound.
3. Is there anything you might suggest to push for a resolution to my leg dysfunction and pain? My quality of life due to this has been severely impacted and I was quite active previously. I can't imagine being left in this condition with so much life ahead of me.
Your suggestions and information are appreciated.
Thank you for your reply. I am under therapy for a 2nd time for "gait disturbance." My ability to move is significantly impacted. My more recent EMG/NCS was normal so was the study to check for cord pressure, an SSEP.
1, Since the imaging provided the measurements of the diameter of the canal at those areas and my leg problems (movement and pain) continue, is that not enough information to establish spinal stenosis?
2. Must the nerve studies be positive first (the initial one was and they found nothing in the imaging for low back origin nor do I have/have never had low back pain)? I can barely get around (movement problem and bad leg pain) and wonder if I will be left in this condition at 46 years of age. I am basically housebound.
3. Is there anything you might suggest to push for a resolution to my leg dysfunction and pain? My quality of life due to this has been severely impacted and I was quite active previously. I can't imagine being left in this condition with so much life ahead of me.
Your suggestions and information are appreciated.
Brief Answer:
If your condition is not improving then surgical decompression can be done.
Detailed Answer:
Hi
Welcome back
MRI measurement of diameter are sufficient to establish diagnosis of spinal stenosis. You are also having clinical symptoms correlating with it. Your movements are severely effected. Your doctor may be doing nerve conduction test EMG etc probably to look for other causes because thoracic disc prolapse and stenosis are relatively less common. but because thoracic spine is less spacious so it can cause severe symptoms. Most of persons are treated by conservative methods but if symptoms are not relieved then operative decompression should be considered to release pressure from spinal cord.
You can discuss with your doctor about it.
Everything else already discussed.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho
Wishing you good health
Take care
If your condition is not improving then surgical decompression can be done.
Detailed Answer:
Hi
Welcome back
MRI measurement of diameter are sufficient to establish diagnosis of spinal stenosis. You are also having clinical symptoms correlating with it. Your movements are severely effected. Your doctor may be doing nerve conduction test EMG etc probably to look for other causes because thoracic disc prolapse and stenosis are relatively less common. but because thoracic spine is less spacious so it can cause severe symptoms. Most of persons are treated by conservative methods but if symptoms are not relieved then operative decompression should be considered to release pressure from spinal cord.
You can discuss with your doctor about it.
Everything else already discussed.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho
Wishing you good health
Take care
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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