MRI Results

[Derrick]

Greetings!

One of my symptoms prior to having Cysto/Hydro was that I was having low back pain in lumbar region. After having the procedure and uro finding pin point bleeding he told me that my low back pain wasn't related to my IC diagnosis.

I finally convinced my PCP to send me off for a L-spine MRI. I've included the detailed report at the bottom of this post, but in summary I've got problems at L5-S1 and also at T11-12.

I've searched the Internet and found this little gem of information on L5-S1:

"L5_S1 is very low in your back, the nerve symptoms in this area would be pain and numbness into your legs, possibly going all the way down to your feet, also bladder problems, bowel problems, sexual dysfunction, loss of coordination and/or weakness in leg or legs. Any continued loss of function means you are probably a candidate for surgery, if you have no loss of or altered function, surgery is a last resort, current medical trend is to give muscle relaxants, anti inflammotory and pain meds, along with aggressive physical therapy, which should include walking, back strengthening and possibly some muscular re education, and instruction on back care. Avoid surgery like the plague."

Here are my questions:

- Has anyone else been dianosed with IC and also had problems with discs in their back pressing against nerve roots?

- Could it be possible that I DON'T HAVE IC and all of my frequency and sexual dysfunction problems be related to my disc problems in my back?

- Could a pinched nerve cause a bladder to be inflamed and have pinpoint bleeding?

I realize that this could be a stretch, but I'm so desperate to find a tangible cause for my frequncy and sexual dysfunction problems.

Thanks!

Derrick

Detailed MRI Report:
CLINICAL INFORMATION: Low back pain. Symptoms have been present for about five years. History of chronic interstitial cystitis.

MRI LUMBAR SPINE 9/13/00:

TECHNIQUE: Using a Magnetom Symphony system, the following pulse sequences were performed: Sagittal spin echo T1 and TSE T2W images through the lumbar spine as well as para-axial spin echo T1 and TSE T2W images through the lower four intervertebral disc spaces.

COMPARISON STUDY: None.

FINDINGS: Numbering assumes the usual five nonrib-bearing lumbar vertebrae. Mild dextrocurvature of the lumbar spine is seen. Otherwise normal alignment is present. Normal bone marrow signal intensity is seen.

The spinal canal is adequate. The conus medullaris and cauda equina are unremarkable.

L5-S1: Peripheral disc desiccation is seen. Mild degenerative facet change is noted. 3mm broad-based dorsal subligamentous disc protrusion is seen with slight inferior extension. This effaces the ventral aspect of the thecal sac. This is situated within the anterior epidural space between the descending S1 nerve root sleeves bilaterally. There is mild effacement of the descending S1 nerve roots. No canal or foraminal stenosis is seen.

L4-5, L3-4, L2-3: No significant abnormalities.

L1-2, T12-L1: No significant abnormalities are noted on sagittal images.

T11-12: On sagittal images, mild peripheral disc desiccation is seen. Minimal dorsal bulge of the annulus is noted.

IMPRESSION: Mild degenerative change at L5-S1. 3mm broad-based dorsal central disc protrusion with slight inferior extension is seen. This effaces the ventral aspect of the thecal sac and proximal descending S1 nerve roots bilaterally. No stenosis is seen.

Thank you for this patient referral.


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[This message has been edited by Derrick (edited 09-26-2000).]

[Derrick]

FionaC,

Have you had a lumbar MRI done before? If not, I'd really encourage you to do so. I had to go back to my PCP two times before he finally agreed to send me. You should have seen the look on his face once the report came back. hahaha (Egg on face)

I've been chatting with an IC research nurse at University of OK (who incidentally has IC herself) about my situation. She thinks it's a stretch, but has encouraged me to follow thru with my neurosurgen on next steps, etc. to see if there is indeed a "connection" between L5-S1 disc and my S1 nerve roots.

One interesting tidbit she mentioned to me the last time we spoke was that the the bladder is connected to nerve roots S3 and S4. It might be worthwile to have MRI done of lumbar spine to see if you have any discs that are pressing against those nerve endings.

Derrick

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[yvette]

Hi Derrick! Thanks for your post! Almost too weird, I posted something re: the same subject around the same time today. Did you read my mind or what?! Too cool!! Again, thanks so much espeically that little tidbit re: L5-S1. you have no idea show much reasearch time you saved me!!!
y.

[Derrick]

Well for those that are interested, I've found a similar web site to ICN discussion forums for spine injuries and for helping folks make sense of their MRI results.

Follow this link: http://neuro-mancer.mgh.harvard.edu/...n/Ultimate.cgi

I've gotten one reply to something that I've posted there. Doesn't seem to have the volume of traffic like ICN does.

[MelanieJ]

Hey Derrick.

Interesting hypothesis...one that has been presented before, with much controversy. However, I remain open to this idea myself. Perhaps not from a stand point of the one and only reason why I have IC, but certainly a contributor. That's great that you have a relationship with that nurse - what a great resource! I'll be interested to hear more about your explorations with this angle. Please post more when you know, okay?

By the way, I had fun looking at your pics on your home page. I haven't met any one else face to face that has IC (besides my physical therapist, who has an extremely mild case). It's nice to see faces to go with the names. I'm not alone!

Melanie J.

[KathyP]

Hi Derrick
My uro. sent me to an ortho. surgeon to see if my spine was causing me any problems in reguards to my IC. He did an MRI,and the findings read; there is a small annular tear of the L4-5 disc with an associated minimal posterior disc herniation. There is no significant deformation of the thecal sac. The L4-5 disc is dessicated. There is no evidence of neuroforaminal stenosis at any level, nor is there evidence of nerve root compression at any level. Then I get a note mailed to me by the ortho.doc. saying I am referred to a neurologist with no reason as to why. So now on Oct12th. I will be seeing this doc. and he is going to do an EMG. I was told by the neuro's sec. that the test is a nerve conduction test to see about my nerves to the bladder. So I will keep you posted as to the outcome. I'm just glad that I do not have to fight for certan tests. I just keep getting calls telling me I am going here and there. I'll go anywhere in hopes of getting some relief from this disease. Just so long as they don't find anything else wrong.
Talk To You Soon
KathyP
PS; my husband had surgery for herniated dics
10yrs. ago and he has constant urg.freq. from
pressure on the nerves to this day.

[This message has been edited by KathyP (edited 09-27-2000).]

[JaneP]

Hi Derrick,
I find it very interesting that so many of us with IC have lumbar disk problems. I have quite a long history with it. Eleven years ago I had back surgery for herniated disks at the L4-L5 and L5-S1. They were centrally ruptured so both of my legs had weakness, numbness, and pain. I recovered well from the surgery. My IC symptoms started about 8 years later. Five months ago I had fusion surgery at the C5-C6 and C6-C7 levels. I am still recovering from this surgery and have numbness and some pain in my left arm. I have recently been evaluated for awful low back and leg pain. The x-rays show the disks at L4-L5 and L5-S1 are totally gone now. I am going to physical therapy now and am having a MRI soon. My doctor fears that I may have some bad stenosis going on now. My bladder symptoms seem to be tied to the low back problems. When the back pain is bad, the bladder is really acting up. What treatment will you be doing for your back? I hope that it goes well for you.

[christina]

Hi Derrick,

I too, have had problems with my lower back. But, I have had it under control since my IC has been under control. I have the same problem as you....my L5 and my S1. When I am in bed for more that a day I have problems with my back but I have found that if I walk and do stretching that I can keep the pain away. I hope this helps you.

christina

[This message has been edited by christina (edited 09-27-2000).]

[FionaC]

Hello again Derrick,
Thanks for your suggestion. No, I have not had an MRI, but will definately be asking my Dr. about doing some tests. (which ones will depend on Ins. I'm sure)
Please keep us posted as to what treatments you will try, and how you are doing.
Take care,
FionaC

[Sparky2]

Hi Derrik:

My bladder problems all began with a rather large herniation at L5-S1. After surgery to correct the disc, the bladder problems disappeared. About 3 weeks later, however, they returned. I soon learned, though, that my disc had reherniated.

Right around this time, I was also told that I had IC because a little bleeding was noted at my bladder neck. I didn't buy the diagnosis since I was absolutely convinced that nerve compression in my back was still to blame for my bladder troubles.

So, taking my cue from the results of my first microdiscectomy, I decided to have the disc operated on again. Unfortunately, though, my "IC" failed to respond to the surgery this time.

In the last few weeks, however, after a year of apparently being misdiagnosed ,
and getting no symptomatic relief, I've been been told by my uro that she believes I have a neurogenic bladder instead of IC after all.

So, what does this mean for me? Well, at present, my whole spine and pelvic region appear to be completely out of whack and my bladder can only hold about 400ccs. Do I have IC, do I not have IC???? Absolutley, no clue...

Tomorrow, I will be getting MRIs of my entire back taken because recent nerve conduction studies that my neurologist ordered, point to my having some sort of central abnormality (whatever that means).

I will tell you, Derrick, that lumbar herniations, as well as thoracic herniations can cause bladder problems. However, lumbar herniations usually result in a saggy, overdistended bladder that empties poorly.

I hope my story helps. I'll post again when I know more. Take care.

Lynne

[joannedorcas]

Hi Derrick,

I Have Pain In The Lower Part Of My Back Right Into My Tailbone, Have Not Been Diagnosed Yet With Ic, But Do Have Symptoms Of Pfd Also, Like Leakage And Straining To Have Bowel Movement, And When Examined If Bladder Is Pressed On Its Very Painful, Enough To Bring You Off Of The Bed, Now Is That Not Part Of Ic Also? I Am Due To Have Cystoscopy Sept 12, Seen Uro Aug 15/ And Told Him My Symptoms And Had Them Wrote Down And He Told Me He Didn't Think I Had Ic But Scheduled A Cystoscopy, All He Did After He Said That To Me Is That I Am Too Tight And I Should Go To Palodies Or Yoga, Whats This, Too Tight, Nice Compliment But I Had 6 Kids. Give Me Your Insight On This And Check Me Out On Not Yet Diagnosed.

Thanks
Joanne

[joannedorcas]

Derrick,

I Missed Part Of My Message I Was Writting You, After He Said That To Me He Gave Me And Pelvic Exam, And Said Yoga Or Palodies.

Joannedorcas

[SandyRN]

i posted a reply to this then erased it because it's from the year 2000 and most of the people involved in the thread aren't around anymore.

[sweet candy]

I cant believe the info i am reading i too have L-4-5 problems and facet joint degeneration, what is the whole link nerve route? could this lead to other organ disfunctions such as bowel incontinence and pressure in lower back?