My Thoracic Discography - NEGATIVE

[Tbackpain1]

Aaron,

I tend to think that while there's no direct correlation between a thoracic nerve and not being able to speak, there is definitely a link between high pain levels and the Vagus Nerve. This nerve is part of your Autonomic Nervous system. When I have very very bad flares with the t-spine pain, I get a classic Vagus Nerve response (rapid heartbeat, clammy skin, etc) and I have passed out a few times as well.

The vagus nerve is either one of two cranial nerves which are extremely long, extending from the brain stem all the way to the viscera. The vagus nerves carry a wide assortment of signals to and from the brain, and they are responsible for a number of instinctive responses in the body. You may also hear the vagus nerve called Cranial Nerve X, as it is the 10th cranial nerve, or the Wandering Nerve. A great deal of research has been carried out on the vagus nerve, as it is a rather fascinating cranial nerve.

Vagus is Latin for “wandering,” and it is an accurate description of this nerve, which emerges at the back of the skull and meanders in a leisurely way through the abdomen, with a number of branching nerves coming into contact with the heart, lungs, voicebox, stomach, and ears, among other body parts. The vagus nerve carries incoming information from the nervous system to the brain, providing information about what the body is doing, and it also transmits outgoing information which governs a range of reflex responses.

When the vagus nerve is stimulated, the response is often a reduction in heart-rate or breathing. In some cases, excessive stimulation can cause someone to have what is known as a vaso-vagal response, appearing to fall into a faint or coma because his or her heart rate and blood pressure drop so much. Selective stimulation of this nerve is also used in some medical treatment; vagus stimulation appears to benefit people who suffer from depression, for example, and it is also sometimes used to treat epilepsy.

[Tbackpain1]

I'm sorry to hear that you're having that horrible wrap-around pain. Any word on the ESI? Are they going to consider attempting to knock out C7-T1, or are the going to address t-spine only?

Its just crazy how closely related some of the nerves are, and the cross over of dermatomes can vary from person to person, injury to injury. I've been getting horrible high thoracic pain lately with the increase in workload (yay new clients! but man my spine is not happy about the extra computer/keyboard time).

I hope that conservative tx and lifestyle changes will help eliminate some of your pain. My chiro has been on me to make sure I am changing postion frequently...sometimes something as simple as that can make a difference. After so long dealing with these issues, Dr. Reul is right, we do look at things with "orthopedic goggles".

Be well.

Theresa

[mmglobal]

Theresa, it's great to see you here. I am soooo glad that you have improved to the point where you can work again. You were pretty far from that point when we met in NY for my 2005 patient symposium. (I just checked the photos on the GPN events site... you are there.) Great news (and hope for many of us t-spineys.)

Aaron, sorry I missed your question. We only tested one level. No need for a control disc for me. I'm very lucid in spite of the severe pain and know exactly what is happening. The clear positives and clear negatives we have gotten obviate the need for control disc. If I was hypersensitive and reporting high pain there would be need for control. Certainly with a negative discography, a control disc would add no data. In spite of the belief that discography is safe, I don't want to poke a hole in a disc unnecessarily. (Risk of damage or infection is low, but not zero.)

Based on Dr. Baumbach's recommendation, I had 3-Tesla MRI of cervical and thoracic spine last Thursday. I did an extensive review with Dr. Reul... no new data, nothing interesting. No new pathology seen in c-spine.

I told him how disappointed I was with the negative costovetebral ablations, especially after such conclusive results of the diagnostics.

He said that he was being especially careful with me, using low amounts of energy in the ablation to avoid permanent wrap around numbness that is not uncommon with this ablation. See the thread linked below for more discussion.

He recommended repeating the investigation to determine painful levels. If data is reproducible, he suggests redoing the ablation, but a little more aggressively. I think that is a fine plan and will proceed with that... next time I can get back to Bonn.

I'll repost this on the costovertebral ablation thread... the story will continue there.

CT Guided Costovertebral Nerve Ablations

Mark

[Aaron]

Mark,

Have you any experience with these? I know they are weaker in strength, but I have heard in certain cases they revealed a more signifigant cord impingement than previously found. I thought that would be the case with myself since I have no pain lying down ( trad. MRI) , but the only new finding was some stenosis in the lower end of thoracic. Just wondering if the upright MRI would be of any use in your case.

[mmglobal]

Aaron, the upright MRI's may show up pathology that is not present when our spines are unloaded. Kind of like the flexion extension images, we hope that images in more realistic situations will yield more info than the static, neutral images.

In theory, I see the functional MRI's, standing or sitting MRI's being very useful. There are amazing examples of big disc herniations apparent under load, that are not present in a neurtral position. In practice, I have yet to see a smoking gun under standing MRI that is not present in prone MRI.

Nobody has suggested it for me. I'd try it if someone suggested a need for it.

That's the long answer. The short answer is no... not much experience with standing MRI here (except the dozens of clients with them... but nothing extraordinary shown.)

Mark

[Crystal33]

Mark,
Maybe decades from now they will be able to take MRI or some image that can show what the problems are down to a cellular level, and the software might even be able spit what the problem/s are. But for now I still think the technology is fairly crude, sometimes helps, but at other times leaves people as radiated pin cushions, with no real help. And the risky surgeries best avoided, unless critical, or unless failure of extensive conservative care.

It is low tech, but do you follow a daily physical regime tailored for your condition, including things to do, and things not to do or to minimise?

I blew a hole thru thoracic disc with a loose piece pressing on spinal cord 22 months ago. Operation was considered hi risk and months on back followed then a slight 'lift' in my condition every 3 or so months. Now I have very little pain, l get around ok, started light daily swimming, but still very conservative with any bending or lifting or consecutive hours on feet. I ended up taking a view that your body tries to repair problems but can only do it one cell at a time, over a long period, though not likely ever as good as before the damage. I know nothing about how a broken leg heals, but my body knows everything.

Could a combination of things like daily posture awareness, light core conditioning, minimise static sitting, lie down a few times day, or other things help? Very easy swimming with a bit of added buoyancy unloads spine, gives gentle motion, stretching, and controlled breathing ....might help thoracic area. Even add glucosamine for joint issues. So maybe a combination of modifications, and things done every day might help with the pain very slowly but surely like an extra drop of water in a glass each day compared to losing a drop from the glass each day.
Just my thoughts.
regards

[Maria]

I'm wondering if the incidence of thoracic disc problems are higher in persons that have had lumbar and/or cervical surgeries (ADR and/or fusion).

It would seem that T-spine injuries can happen for any reason and more so w/certain activities (weight lifting? jobs that require use of upper body strength?) though I do wonder if persons w/other areas of weakness and surgery w/instrumentation are higher in incidence w/t-spine probs as well, incidence higher in males vs. females?

I have slight scoliosis at T7 and have had only several incidences of a pain in that area that is piercing and literally takes my breath away demanding absolute stillness and a fear of exhaling or inhaling.

My OSS said long ago before my cervical spine started to bother me that my Tspine where bra clasps in back would be next to bother me because of DDD there. So far so good.... probably lifting one bag of kitty litter away from disaster anywhere in my spine tho I often wonder if not upsetting the status quo of my spine any further re surgery to date has kept it relatively stable (even w/DDD thru-out). This is not to say that if one area demanded surgery I'd forego it~ just pondering.