My Thoracic Discography - NEGATIVE

steve55 · #1 (**permalink**) 03-23-2011, 03:56 AM

Well, Mark, .... it looks like we both had our procedures today. I had facet injections at c4 and t1. It's the first diagnostic step for me that might ultimately lead to a thoracic discography myself. I'll be interested in seeing your next update.

mmglobal · #2 (**permalink**) 03-24-2011, 02:29 PM

Discography is done. I can't say enough good things about Dr. Reul. I have heard so much about how difficult and risky thoracic discography is. Some of the doctors I know who do discography warned me against it. When they found out that I was having it with a doctor with a great deal of experience with CT guided discography, they were more relaxed.

Having been in the procedure room observing more than 50 discographies, I have seen many that were very well done, and some that were not so well done. This was my fifth discography and my 11th level tested. As with all the two other needle procedures I had with Dr. Reul there was no sedation. However none of the past procedures were discographiy.

This procedure may have been the easiest of all the needle procedures I've experienced. Dr. Reul's caring, skill and experience are amazing. The pain I experienced on needle placement was very minor. He would get the needle close to where he wanted and take an image. He'd adjust the needle placement and repeat the process. There was not an intense pain when he penetrated the annulus as I have felt on other discographies. I was surprised to learn when he was all the way into the disc.

When he pressurized the disc, I felt a low-level pressure. At times I felt a very momentary sharp pain that shot horizontal across my ribs. People with thoracic problems will know that pain. However, none of what I felt was "my pain". My notes say 5 - 6 out of 10 NON concordant pain. Negative test.

I didn't know whether to be happy or sad. I'm glad that I'm not looking at thoracic fusion. I'm sorry that we still don't know what the problem is. Dr. Reul suggests going back to the facets. I'll write more later. I don't want to type a lot now.

Here are some of the images from today. The post-disco CT shows a pretty typical degenerated disc's distrubution of the contrast. The red arrows point to an accumulation in the 'sub ligamentous' space. The disc is herniated with an open annular tear. However the herniation is 100% contained by the posterior longitudinal ligament.

Note how narrow and curved the space where he needs to get the needle through is. This is why this should only be done with CT guidance and by someone with a great deal of experience. You may ask, "how can a doctor gain the experience?" The answer is, ON SOMEONE ELSE!

Mark

Maria · #3 (**permalink**) 03-24-2011, 04:33 PM

Hey Mark,
Was reading what you wrote and sent a chill up my spine just at the thought of neede placement at that level. Glad you got it done by this experienced practitioner, glad to hear it's negative and you can avoid fusion. Hope if it's the facets this will be determined and you can get a treatment plan that works for you.

Nice films. Thanks for explaining them. Hope if you're traveling back home soon that all goes smoothly and comfortably.

dshobbies · #4 (**permalink**) 03-24-2011, 07:00 PM

Damned if you do, damned if you don't - sounds like your back. What comes next?

I'm sorry you're suffering so. It's simply not fair

Dale

jsewell · #5 (**permalink**) 03-24-2011, 07:08 PM

Mark i am sorry this was negative and you need to further search for your problem. Glad it was a low pain procedure though , especially if it did not show your problem.
My back fusion kind of acts up only a little bit now. But NONE of that horrible pain . So i am glad i did it.
judy

newhere · #6 (**permalink**) 03-24-2011, 08:59 PM

Mark i am sorry for discogram...at least you know you will not need thoracic fusion,so thats good. I'm wishing you that dr. can set some proper diagnose for your thoracic pain. I will go also to Bonn to see some options for my thoracic because the pain must have the main source. I will open in a few days a new thread about understanding relations between my friends,environment etc... & me. It's very hard to live like this...not even my family understands me.
So thats why i look at you Mark as my other father who is willing to help me. Thanks alot

hear u soon

steve55 · #7 (**permalink**) 03-25-2011, 02:02 AM

At least that is one step closer to proper diagnosis. I've been doing quite a bit of research on thoracic discography and everything I've read seems to say it's safe and effective as part of the diagnoses process.

"When performed by a skilled and experienced technician, thoracic discography has been shown as quite safe with a very low rate of complications"

Over and over I see studies that say that MRI's can and often do miss tears and many other painful pathologic disc conditions.

So far my injections haven't helped at all. I'll be pushing for my thoracic discography as soon as possible.

Anyways, good luck Mark. It will be interesting to see what other tests you will be undertaking as I may be following suit.