Should I be worried?

[spitfire]

Meds

Ed - I've taken steroid packs while waiting for a nerve block but never prescription NSAIDs. My doctor apparently ~thought~ he gave me prescription NSAIDs because he argued with me that my hair loss was from the drug and not the nerve block. (Three months after each nerve block, I lose a LOT of hair.) I declined another nerve block this time because the hair loss just adds insult to injury. I agreed that if the therapy doesn't stop the numbness in my leg, I'll reconsider the nerve block. So, this time he did give me a prescription NSAID, Meloxicam, which he said 5 minutes earlier could cause hair loss.... And he gave me muscle relaxers for sleeping because I'm not. They do help me get comfortable and sleep, but I've a couple of rough days afterwards.

[rohrer01]

Welcome, Spitfire!

I am an adult in your age bracket with progressing scoliosis and severe sciatic pain from my lower back to my toes, worse on the left. I looked at your x-rays and you do have rotation and your spine does NOT look like a 70 year old spine. I don't see any disc spurs from osteoarthritis or one vertebra sitting on top of the other. You seem to have decent disc height. What I did notice was your SI joints are not the same. The space between the ilium and sacrum is much larger on the left than it appears on the right. This may be a cause for your feeling of instability. I get frequent (about every three to four months) SI joint injections and they help about 75% with the pain when the doctor gets the right spot. However, I have DDD in L5/S1 that still kills me! I can't stand for very long. They say it's stable, but it is very painful. They still have offered nothing to do for it. I have a multitude of other things wrong with my upper back and have some unknown muscle disease which is slowly taking my strength and ability to walk. However, I don't think this is necessarily related to what's going on in my lower back. I've developed a very small 6^o curve in my lumbar, so don't be embarrassed by your 22^o curve. There are a ton of nerves that are spread out and run through that area. It doesn't take much to pinch one or two.

Again, welcome.
Rohrer01

[rohrer01]

Sharon,
Look at the spinous processes again. They should look like little vertical disc shaped shadows that are centered. You should not see the sides of them or see them off center.

[spitfire]

Thanks Rohrer. I was hoping to hear from someone my age in a similar situation. I know no one has a crystal ball. I guess I'm impatient while waiting for my next appointment.

I wasn't experiencing any instability when this X-ray was taken. This is the closest thing that I have to a "before" picture. This was made in January 2010 when I first saw a doctor for disc issues.

I had a few episodes of a weird (and extremely painful) wobbling feeling in my lower spine in November 2015. I thought the instability might be related to extending my back while snorkeling with a noodle. (I needed the noodle because I'm a wimp who is afraid of the ocean. I kept popping my head out of the water to count children because I'm a mom who is afraid of the ocean.) X-rays in January 2016 showed a 42 degree curve. I wasn't expecting the curve to change that much.

[Pooka1]

I wasn't expecting the curve to change that much.

If you indeed have AIS and you progressed from 18* at skeletal maturity to 42* now, that completely is off the reservation for what is presently considered the paradigm of treatment. That is, if you can keep the curve to south of about 30*, you are not expected to need surgery for progression at least. Nobody ever talks about these patients ever needing surgery for pain though.

Maybe you are just a rare case and maybe you are not. The way you get kids to wear the brace is to suggest it will let them avoid surgery for life. If the truth is something other than that for many people either due to pain or progression even with brace treatment then it is false advertising.

[Pooka1]

Sharon,
Look at the spinous processes again. They should look like little vertical disc shaped shadows that are centered. You should not see the sides of them or see them off center.

I can't upload the file but this is what I did.

I have drawn a red line on the ridge at the midline of each vertebra. There is equal mass on either side of those lines for each vertebra. The lines remain centered on the vertebra. If there was rotation, those lines would be off center and there would be unequal mass on either side of each line. Yes?

[leahdragonfly]

Welcome. <snip> I looked at your x-rays and you do have rotation and your spine does NOT look like a 70 year old spine. I don't see any disc spurs from osteoarthritis or one vertebra sitting on top of the other. You seem to have decent disc height. What I did notice was your SI joints are not the same. The space between the ilium and sacrum is much larger on the left than it appears on the right. This may be a cause for your feeling of instability. <snip>

Just a friendly reminder that while many here have seen lots of spine x-rays and mean well, we are all lay people, and no one here is terribly qualified to accurately discuss x-ray findings, especially degenerative changes. Qualified spine orthopedic surgeons are the best source for that sort of advice.

Good luck with your upcoming appointment.

[titaniumed]

Ed - I've taken steroid packs while waiting for a nerve block but never prescription NSAIDs. My doctor apparently ~thought~ he gave me prescription NSAIDs because he argued with me that my hair loss was from the drug and not the nerve block. (Three months after each nerve block, I lose a LOT of hair.) I declined another nerve block this time because the hair loss just adds insult to injury. I agreed that if the therapy doesn't stop the numbness in my leg, I'll reconsider the nerve block. So, this time he did give me a prescription NSAID, Meloxicam, which he said 5 minutes earlier could cause hair loss.... And he gave me muscle relaxers for sleeping because I'm not. They do help me get comfortable and sleep, but I've a couple of rough days afterwards.

There is not much chatter about Meloxicam here on this forum that I have seen, and have NO idea about hair loss. I never did any corticosteroid shots for herniated discs only due to my prior regular ortho’s confused staff. Surgeons have to have good staff or it really causes a lot of pain....Communication is best done by e-mail from the doctors PA or nurse.

I did take a medrol pack for my cervical herniations, and along with Diclofenac that worked after 30 days of intense pain. Nerve pain or disc herniation on the cord really is a pain that is an “alarming” burning sort of pain, unlike any other pre herniation pain living with scoliosis. It becomes critical because you cannot sleep well when you are in pain and you become sleep deprived. Lumbar herniation’s affect the hips and legs, neck herniation’s affect the arms and hands.

Years ago when I was suffering with my 4 lumbar herniation’s, I really had to lay low. My activity almost came to a standstill and sitting was extremely difficult. NSAID’s, hot tubs, and massages were the norm back in those days. Ocean therapy worked, I even had a situation where I was a passenger in a car, supporting and lifting my spine by holding or pushing down on the seat. We hit a bump in the road and I self adjusted myself which helped.

Please be aware that NSAID’s can also cause cardio problems, never abuse or overtake these meds.....

The easiest way and fastest way to pain relief will be by floating in a hot tub. Even after my surgeries, I used a deep tub, and at 106 deg F it works in seconds. I felt that the Percoset and Oxycodone was more of a mask and those orals don’t work well on nerve and bone pain......If you tub, drink a lot of water. I took many hot soaks at the famous Steamboat Hot Springs. If it was good enough for Mark Twain, it was good enough for me.

I tried Robaxin many years ago and felt that it was weak. I never took muscle relaxers after that point...1978 era...

A latex foam topper on the bed will help with sleep....many surgical patients use them after surgery....

If you shoot MRI’s or X-rays, get copies burned to disc for your records. They are your property, don’t let the radiologist assistant give you any guff about this. CT’s produce a lot of radiation, if possible, do this as a last ditch diagnostics effort.

Also, be astute on exactly HOW MUCH the co-pay is on your diagnostics. My co-pay on my last MRI caused more damage than the herniation’s themselves.....(smiley face) You can also shop diagnostics for cash deals since dealing with insurance companies can be a pain in the (insert location here)

I cant comment on rotation in your x-rays.... I had HUGE rotation in my thoracic spine, it comes with scoliosis, and have CTs that show this. This is feet to sky looking up. You can see the screws after correction. The screws are approx 30 degrees after correction. These CT’s were done when they were looking for stones when I was having gall attacks in 2009.

Ed

[rohrer01]

I can't upload the file but this is what I did.

I have drawn a red line on the ridge at the midline of each vertebra. There is equal mass on either side of those lines for each vertebra. The lines remain centered on the vertebra. If there was rotation, those lines would be off center and there would be unequal mass on either side of each line. Yes?

Sharon,
If you look at each individual vertebra you can see that T12 - L4 are all off center from the vertebral body. That's rotation. I don't know what her new x-rays look like...

Linda will correct me if I'm wrong about how to determine rotation. But it only makes sense that if the spinous processes aren't dead center on the vertebral bodies then they are rotated.

[Pooka1]

The central ridge appears dead center on all vertebra. What am I missing?

That is not the OP's radiograph but rather one that Linda found.

[rohrer01]

Just a friendly reminder that while many here have seen lots of spine x-rays and mean well, we are all lay people, and no one here is terribly qualified to accurately discuss x-ray findings, especially degenerative changes. Qualified spine orthopedic surgeons are the best source for that sort of advice.

Good luck with your upcoming appointment.

Maybe the doctor was talking about how her spine looks NOW, not when these x-rays were taken. I've made no claim to be an authority on the matter. I just know what I've been told about my spine and how my x-rays look as compared to how hers look at our age and I don't see a 70y/o degenerative spine. I've seen degenerative spine x-rays on both my ex and my current hubby who were neither nowhere near 70y/o and they were much, much worse.

There is a disclaimer on the forum entry that we are laymen, so that should cover our "opinions". If she wants to know my qualifications, she can ask.

Not trying to be snarky, just sayin'. We all discuss our x-rays and give our opinions. It's all over the forum. I totally agree with you that a scoliosis orthopedic surgeon is the best source of advice. But I've been told by several doctors that my neck is a MESS and they were orthos not specializing in scoliosis. The scoli orthos say it's not that bad. So, who do you believe? Of course, you take what you hear on the forum with a grain of salt. But it really can give one ammunition for questions to ask the doctor AND send them to the right doctor.

[rohrer01]

The central ridge appears dead center on all vertebra. What am I missing?

That is not the OP's radiograph but rather one that Linda found.

Then what radiograph are you looking at? That's the only one there...???
I'm looking at post #6.

[Pooka1]

Then what radiograph are you looking at? That's the only one there...???
I'm looking at post #6.

Post #11
.

.

[rohrer01]

Post #11
.

.

So post #6 isn't her radiograph?
I'll look at post #11. I must have missed it. I was basing everything I said on post #6...

[rohrer01]

I saw Linda's post on post #11. Those aren't Spitfire's radiographs. Are those the ones you are looking at for rotation?