Question
I went into your website and sent and email regarding the glossary as I was looking for the above.  So I am resending my email to you as I am not sure if you would read the other...
Hi,

After an MRI, my sister was diagnosed with a bulging disc--needless to say she is in an extreme amount of pain--and they also found "spinal bone marrow edema".  I have searched the web and did not find anything specific about "spinal bone marrow edema".  She is also experiencing a numbness in her foot which she has no idea why this is happening.  

Can you please explain to me what "spinal bone marrow edema" is and if the bulging disc can cause this problem?

Thank you,

JoAnn Chadwick

Answer
Dear JoAnn,

Spinal bone marrow edema is just fancy terminology for swelling in the bone marrow.  They can see this on an MRI because the swelling creates an increased signal on the MRI film indicative or increased water content in the bone marrow.

The bone marrow is found centrally within the bone and carries the nutrition needed to support metabolic processes inside the bone.  The disks get all of their nutrition from  diffusive process of pumping the blood in the bone marrow across the endplates of the vertebra into the disk.  Therefore if there is edema in the marrow this can create increased swelling in the disk as well, or at least more of a chemical irritation to the already injured disk.

Now, the pain she is having is common with an acute disk bulge.  The numbness in her foot is being caused by the disk either pressing on the exiting nerve roots / spinal cord, or a chemical irritation to the exiting nerve roots / spinal cord due to the inflammation in the area.  This is also common with disk bulges and it gets worse as the disk bulge increases.  The most common nerve roots affected are the L4, L5, and S1 nerve roots.  Think L4 on the inside of the foot, think L5 on the top and near the big toe, and think S1 if on the outside and bottom of the foot as a general guide.

If you go back to my website, you will find that there are illustrations of the vertebral anatomy of what I have described, as well as a detailed page on disk bulges / herniations.  Furthermore, you may wish to read the differences between radicular pain, sclerotogenous pain, and neurological pain in the glossary section to give you a more complete understanding of the issue.

Hope everything works out.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net