Question
I am in constant pain and I can not get any straight answers.  I am a 28 year old male and no symptoms of any spinal pain until 2 years ago.  Can you please give me your interpretation of these findings.  I have consstant uper and lower back pain.  The pain in my neck is reocuring and worse.

Impression:
1. C5-6 and c6-7 disk herniations causing moderate central stenosis and cord impingement.  Although there are chronic endplate spurs, the disc herniations are age indeterminate.
2. Moderate to moderately severe lateral recess and foraminal stenosis at these levels which may impinge the right c6 and bilateral c7nerve roots above.
3. Moderate c4-c5 disc protrusion causing mild central stenosis and moderate foraminal stenosis which may affect the right c5 nerve root.  This is age indeterminate.
CT-Spine
minimal right paracentral t9-10 disk bulge without significant stenosis or impingement.  Mild right paracentral t11-12 disc protrusion causing mild lateral recess and foraminal stenosis.  This has a chronic appearance with slight associated endplate proliferation.
The remaining are intact.
L-Spine
L1-2 Mild posterolateral disc bulges causing mild lateral recess and foraminal stenosis, greater on the right.
l2-3 through l4-5  Mild disc bulges causing bilateral foraminal narowing.
Moderate l5-s1 disc protrusion and facet arthropathy causing moderate lateral recess stenosis abutting the intrathecal s1 nerve roots bilaterally.  Moderate multifactoral foraminal narrowing abutting the existing l5 nerve roots. These findings are age indetermanent

Answer
Dear Keith,

You have multiple areas of degeneration throughout the spine which should be considered advanced for your age.  I do not know, but would suspect that you have been in multiple traumas in the past years, because this is not what a 28 year old spine should look like.

NECK:  The fact that you have endplate spurs means that the problem has been here for a minimum of 5+ years, and this has been going on for awhile.  The disk bulges in the neck are pretty bad.  Anytime the word "stenosis" is used, it means that the bulges or degenerative spurs are reducing the area the nerves and the spinal cord have in the spine.  This results in inflammation, pain, and often numbness and tingling.  The next step is that you may start to lose muscle strength and mass.

MID BACK:  Again there is degeneration...again this should not be in a 28 year old spine.  The T9-10 bulge not too bad, but the T11-12 bulge can easily be causing pain, numbness to the right side of the body.

LOW BACK:  The lowest part of the lumbar spine is the worst problem here.  Facet arthropathy is degeneration of the joints in the low back.  Specifically the cartilage gets worn down and bone deposition occurs at the joint space.  Facet pain can be intense and sharp, and coupled with bulging disks, it can been even more profound.  The fact that the L5 and S1 nerve roots are being encroached upon is not good.  This usually results in pain down the leg to the outside of the calf and foot, and if progressive can lead to "foot Drop" which means that your ability to walk will be impaired.

Bottom line here is that conservative measures like chiropractic care are absolutely appropriate, however, you may actually need some surgical interventions.  I would encourage you to look into a few options first and then get a surgical consult for diskectomy.  

Even though intervertebral disk decompression therapy can be expensive, I would suggest that you find a chiropractor who performs it in the neck and the low back.  Negotiate a fair price for care to include in house rehab for the neck and the low back.  I would consider $2500.00 for one area a very fair price...but many offices charge upwards of $6000.00 for this care.  If you can get the neck and the low back worked on for $5000.00 that would be a good option...and yes they can bill insurance for this.

Also you may want to explore something called Chiropractic Biophysics (CBP).  With the degeneration you have present, I am sure that you spine has abnormal structure according to the normative data.  Even if decompression alleviates your pain, it will not fix the spinal shape, and this will only lead to more degeneration down the road.  CBP has proven spinal protocols for regaining the normal shape (curves) of the spine.  You can check this out on the Internet at:  www.idealspine.com

Good luck Keith.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net