Question
My Question is:

MRI Reports:

There is a disc protrusion/herniation at T5-T6. This is primarily a right paracentral disc protrusion. This also deforms the ventral cord. There is no central canal stenosis. There is no significant neuroforaminal narrowing.    

Can you please tell me what this means is terms that I can understand?    

I do have very severe back symptoms, that I have had for a long time. I have had 2 surgeries already, but still no relief. I am still seeking treatment currently, but would like to know what these results mean in terms that I can understand.   

My current symptoms are excruciating chest pain...associated with my back problems. The pain is in my upper thoracic area, wraps around my rib cages and causes pain, numbness, and tingling in my right arm. I also get some very severe pain on the right side of my back.    

I had spinal fusion surgery on my T8-T9 disc which they thought was the problem, but I got no relief. Then I had my hardware removed, and still have all the same pain. This pain is so bad I cannot work or function on a daily basis.    

I am wondering since my MRI reports that the herniation is primarily a right paracentral disc protrusion, if this could possibly be the disc that is causing my pain?    

It makes me wonder if possibly they fixed the wrong disc, since I got no relief from the first surgery.

All of my pain and symptoms match up with the area of where the T5-T6 disc is in the spine.    

The MRI also reports that it deforms the ventral cord. Does that mean the bulging disc is pushing on the spinal cord?    

Could that be what is causing the numbness and tingling in my right arm?    

Thanks again for any information you may be able to give me. I am just trying to get information and research these questions, so that I know what kinds of questions to ask my surgeon.

I do understand that you may not be able to answer my questions since they are regarding the thoracic spine, but I thought I would check just in case you could give me any advice.  

Thank you in advance,
Dena Cline

Answer
Hi Dena,

I am not quit sure what this means,

"I do understand that you may not be able to answer my questions since they are regarding the thoracic spine"

Why wouldn't any expert on spine not be able to answer this?

You are correct, the disc is pressing on the spinal cord, the thecal sac is what surrounds the cord so pressure will cause the symptoms you have except for arm involvement.

Get the MRI that justified the initial surgery, if the wrong level was cut, you have a good lawsuit.

It is common after discectomy (surgical removal of the disc) to have poor outcomes. This is why spine surgery is the last resort. Disc herniations above and below surgery often herniate due to the changes in biomechanical stress. It is very rare to have disc herniations at these levels, I would want to find out why they herniated in the first place. I suspect trauma since disc loads are much higher in the neck and back.

The doctor that ordered the MRI should be the one to explain it, why this wasn't done may be reflective of future care.
Before digging your way into a deep hole, get multiple opinions regarding current treatment options before you end up permanently disabled.

Herniated discs have a proven treatment solution for almost 30 yrs, flexion/distraction is the gold standard for treatment and is effective over 90% of the time when applied correctly.

I hope this was explored as an option before surgery. This should not be confused with traction since they are light-years apart regarding outcomes and biomecanical effect.

Right arm involvement should raise concern for possible multiple level disc problems, a cervical MRI should be high priority and next on the list.

The thoracic MRI is clear, the disc is protruding into the spinal cord on the right side in the middle of your back at the T5/6 level, this should respond nicely to F/D.

To comment further I need history of condition, age, medications, underlying disease or illness, post-operative care details (if any) and past conservative pre-operative care measures utilized before surgery.

If you read past questions in the "spine surgery" section, you will soon find yourself in good company with irate people given the false impression that surgery would help their problem. More often than not, surgery worsens the patients condition and should only be considered after all other options have been exhausted.

There is little doubt that the disc herniation at T5/6 is causing the symptoms in your chest and there is no doubt surgery is not the first option.
You can't reverse what damage has been done by the first surgery but you can prevent further damage by getting the proper treatment; this starts with reading up on the condition.

Below is a link on the treatment, don't let any surgeon talk you into skipping this proven remedy.

http://www.coxtechnic.com/homepage.asp

If you go to a surgeon, chances are you'll get surgery. When all you have is a scew driver in hand, everything looks like a screw. Unfortunately, you were on the receiving end of this handy work.

I would concentrate on getting the pressing issue (current disc herniation) taken care of, then dig into why things went wrong.

I can recommend a qualified physician to decompress the thoracic disc if possible, it depends where you live and what type of care is available.

After treating thousands of herniated discs, I can count on one hand how many needed surgery, the vast majority (99%+), recovered fully. On the other hand, study after study has shown 90% of spine surgery is unnecessary, of those, all of them create scar tissue restricting normal range of motion with possible devastating outcomes. Once you have surgery, successful or not, your body will never be the same, the cure is often worse than the disease.

Please understand that this observation is especially unique to spine surgery and not necessarily representative of other surgical procedures. Please e-mail me for follow up questions and additional information, I would be happy to guild you properly through future medical issues.

[email protected]

Good Luck!

Dr. Timothy Durnin