Question
QUESTION: Dear Doctor,
       Several years back, I changed a flat tire on a company car. In the process of attempting to get the lug nut off, I injured my right lower back (right handed). During the tire change, I heard something pop/snap in my back and my right lower back and upper buttock area went numb. I developed severe back pain and was unable to move the muscles (above my hip line, out across the hip (side abdominal muscle) and right lower back). The pain/numbness continued for months. I was given an MRI, x-rays and ct scan and my lumbar was pristine.  As a result, I took a lot of pressure from both my job and insurance company. I went to a neurologist and he advised it was a facet joint problem and I subsequently underwent 2 facet rhizotomy抯, with no relief.

I discovered after some years that there was a change in the dermatome charts and when the new chart was used, they discovered compression fractures at T11, T12?

Are these new charts correct? Please see attached old and new chart.
         Respectfully Yours Marty

See Old 1948 chart at :http://www.merck.com/mmpe/sec16/ch206/ch206a.html#sec16-ch206-ch206a-33

Redrawn from Keegan JJ, Garrett FD, Anatomical Record 102:409?37, 1948; used with permission of The Wistar Institute, Philadelphia, Pennsylvania.)
Sensory dermatomes.






see New Chart at: Dorland's Illustrated Medical Dictionary
Copyright 2007. An Elsevier publication. All rights reserved.






ANSWER: Hi Martin,

I am not sure how one can diagnose a compression fracture from dermatome charts.  Am I misunderstanding that question?  If so, please repost.

The charts are generalizations.  There is a great deal of overlap from one segment to the next.  More current data or simply a difference in interpretation of the same data will cause many changes.  So, you will note differences in various books in the same year!

I would lean toward the more current information.

I will examine the sites mentioned.  If there is any significant comment I will repost.

Hope this helps.

---------- FOLLOW-UP ----------

QUESTION: Sorry, I forgot to mention that new MRI's and CT scans were done based on these new charts. T11, T12 show compression fractures and advanced degeneration.
Thanks Marty

Answer
OK.  That fills in the blank.

That being said, the nerve supply will be compromised to some degree.  You won't get symptoms everywhere those nerves go to.

As I noted before there is a lot of overlap/redundant circuitry.  Depending on how good yours is, there may be little measurable effect.

Mechanically, you will certainly notice changes.  Posture, fatigue, possibly pain and so on.

Chiropractic can help you adapt as efficiently as possible.

Do well.