Trying to explain a little

I don't have a lot of software (computer is broken, working in the cloud), but here's a slightly annotated picture of my back:



i-60c9fab0a40243335b3a09e4bdad3ece-palmri_phixr.jpg



To orient you, I'm facing left, the blocky thingies are my vertebral bodies. Hopefully this helps.

Tags

More like this

In general, I try to keep the content of this blog away from my work. I don't do that because it would get me in trouble, but rather because I spend enough time on work, and blogging is my hobby. But sometimes there's an overlap. One thing that's come up in a lot of conversations and a lot of…
There really aren't that many computer ads. Lately, they suck. Annoying Computer Ad I: Apple iPad. Not as annoying as other pad ads (maxiPads, etc) and Huxley likes to dance to the music (the tune that goes like this: da da da da da da da da da, you know the one), but... This ad shows a hand…
Once again, please don't forget about our DonorsChoose drive! Please click in the panel to you left, and go make a donation to help schools get the supplies they need to be able to teach math! Most people must have heard by now that about a week ago, T-mobile released the first Android based…
Prev: September 9th: Dresdener to Neue Regensburger Next: September 10th: Neue Regensburger to Franz Senn Another in the line of mountain climbing posts; I need to get them all out before next year. This one contains few decent photos because I failed due at least in part due to cloud; but its…

Ow, that disc fragment looks as if it impinges on nerve roots. Hope you can get some relief soon. Are those dark strands in the vertebral canal a few of your cauda equina?

Would you mind if I used that image (sans any identifying info) in my lecture to the freshman medical students on vertebral column, spinal cord, and back muscles? I have a couple of transverse section images, but none as good as that for parasagittal.

You're welcome to use my images, although since I don't really know my MR anatomy very well, you're good to double check me.

I wouldn't mind a shout-out if you use them, but either way go ahead.

I have no cauda equina symptoms, mostly L5 and some S1 symptoms.

My wife had disc replacement surgery almost 4 years ago.

The year leading up to it was, needless to say, difficult.

I hope you aren't in any of the level of pain she was in, because...

Damn.

as a neurologist who's seen many patients with similar problems, and as a former patient with the same problem, you have my sympathy.

you might want to check out the American Pain Society Guidelines, available at http://www.annals.org/cgi/content/full/147/7/478

recommendation 4 maybe of interest to you:
"The natural history of lumbar disc herniation with radiculopathy in most patients is for improvement within the first 4 weeks with noninvasive management. There is no compelling evidence that routine imaging affects treatment decisions or improves outcomes. For prolapsed lumbar disc with persistent radicular symptoms despite noninvasive therapy, discectomy or epidural steroids are potential treatment options."

The tricky part of the recommendation is deciding when you've gotten into that "persistent radicular symptoms" phase.

Best wishes.

Thank you, PalMD; I'll definitely reference your blog on the lecture slide. I suspect that more than a few of the medical students will really enjoy reading blogs written by physicians (and some of them may already follow the medical blogosphere).

Software: the GIMP is free, and very good. Different UI from the Adobe stuff, but it's equally capable.

The image: There seems to be a screaming shortage of redistributable medical imagery on the Net. $HERSELF is a very good amateur photographer, and is seriously annoyed that the images I uploaded to WikiMedia of a recent fracture are getting more downloads than her very good photographs.

Your choice, Doctor, but it could help people and do some education.

By D. C. Sessions (not verified) on 05 Feb 2009 #permalink

Oof. Even without being a doctor, I can tell that doesn't look good! You have my sympathies. In the meantime, if you are moving around the hospital with a cane, and if you're really cranky, do people get to call you Dr. House?