Question
Dr. Rahamimov

Thank you for your time.
My question is - I just came from the neurosurgeon office today - I have had 2 lumbar back surgeries, ( great results from both - have lots of nerve damage - my fault for waiting so long)and have degenertive disc diease lots of lower back problems, but have been having pain in thoracic - the Dr, did mri found spur in thoracic and small rupture in neck, then we did the mylo (yuck) went in today  for results the spur is not the problem not as bad as we thought ( thank goodness) I have lots of arthiritis in upper back ( I also have rheumatoid arthritis I am only 46 years) I do have a as the dr. put it I do have a  unreal curvature of the spine (really bad we knew I had it) upon examining the cat scan an other pictures and radiologist report it shows that my spinal cord has moved to one side it is not in the middle - the dr, says he has never seen this (the radiologist has'nt either) and is wondering if that is some cause of the pain -he says the curvature and arthritis are one source of the pain. we have done lots of mri's and cat scans and mylo's ( last surgery was 02) and this has never showed up before.(The spinal cord moving to one side.
  I was wondering if you have ever come acorss this? and what your advice might be. And why it has shifted?
It hurts in the middle of my back really bad. And do trust and have great relationship with my doc.
Thank you - for your time - any suggestions would be appreciated so much,,,

Connie

Answer
Dear Connie,

An a-symmetric spinal cord appearance on CT or MRI can be the result of your spinal curvature if you have a bit of Scoliosis ?the spinal cord goes along the shortest route and that is why it appears asymmetrical. If this is the case, the reason for your pain has to be sought elsewhere.
Another possibility is that something is displacing the cord within the canal. If that would have been the case, your doctor would have surely mentioned it.
In any case, I have difficulties matching your complaints to the radiographic description you have provided. Given that you have RA, I would first search for solutions in the Rheumatologist's office before considering further surgery.
If you can upload your MRI and CTM and send me a link, I will gladly look at them and give you a more precise answer.

Sincerely,

Dr Rahamimov