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I'll page our hemangioma expert....Feelbad...she had one at T1-2 in the cord itself...she can give you more info.

As for the rest of your neck, do you have the report from the MRI? If not, can you get it and post it here?

I also had herniated disks from C3 to C7 and cord compression down to half thickness of my cord. I had a new surgery called a laminoplasty that doesn't involve fusion and it's the fusions that cause all the long term problems with the spine. You may be a candidate and I know you'll find someone who does it in NYC. Another poster here, Webdozer, also had one about 4 months ago.

So if you have or can get your MRI report, post it and we can tell you what it says in plain words and not radiologist speak. That makes it so you can get what you need from your doc. You have to understand THEIR language to get what you need. and it makes life so much easier when you understand what they are talking about.

There is hope!

hugs............Jenny
Funny you asked I just had the thoracic MRI a couple of days ago and going to find out the results tomorrow. I do have extreme pain in my right arm and shoulder which has caused me to be out of work for approximately six weeks now! I am a legal secretary and it is unbearable to sit in the the chair for 8 hours and type with my right arm! I did have the cervical epidural injection last week and I am scheduled for the cervical facet injection next week! The spinal surgeon did not see the lumbar or thoracic results as of yet so I dont know what he will suggest for those issues. I really didnt want to be out of work this long but this pain is unrelentless and have to take the pain pills and muscle relaxers round the clock not to mention restless night sleeps! I really hope the injections work as well as chiro and PT so I can get back to life in a couple of weeks! The doctors have told me it does take about 3 or 4 months to get back to feeling better after an automobile accident but I guess I am so impatient and so are my bosses! Thanks for your reply is it very much appreciated! As for the hemangioma I am hoping the thoracic MRI will show more! Thanks again!

Joanne
Hi Joanne....sorry I'm just getting to your MRI results now but I had a bad weekend myself....go to see if I have surgery on Wednesday.

So I'll try to explain your MRI results so that you understand them. Where they give you that long list of vertebrae with "hypertrophic" changes, that basically means arthritis as well as changes in the ligaments around the joints. If you were to look at the spine from the top down with the vertebra cut in half, you'd see the front of the vertebra is big disk of bone, round in shape, and in between each vertebra is a disk acting as a cushion between the bones. Behind the disk of bone is the hole where the spinal cord is. It has a covering called the Thecal Sac and that holds spinal fluid in around the cord. And then there is some room for the entire cord and covering to move within the spinal canal. The canal is anywhere from 12-18mms wide and the cord is usually about 11-12 mms. wide.

The disk is a hard but flexible "doughnut" that sits right in front of the canal...literally abuts the canal. Inside it is softer with a harder ring around it to hold the contents inside. With age or injury, that hard outer ring can develop a soft spot and cause the entire thing to bulge out the side or it can actually rupture and the insides then come out(herniated disk)and form a smaller 'width wise" bulge but often longer as it squishes out and can continue to squish. So when a disk starts to bulge, if the bulge is backwards, then it hasn't far to go to hit the Thecal Sac and then can push even further and hit the spinal cord. This is what you have at C3-4, C4-5 and C5-6. The only difference is where the bulge stops. At C4-5, the disk is hitting the thecal sac and your spinal cord but at the other 2, it's only hitting the sac and just touching the cord(means no signs of indentation in the cord).

Luckily for you, the big pain maker is when these bulging disks also hit the spinal nerves. These are nerves that peel off the spinal cord at each vertebra(kind of like peeling a banana) and exit through small holes in the vertebra and go out to the body. The cord, like the brain doesn't feel pain but those spinal nerves hurt like he!!. But those nerves and the tiny holes they go through are okay for you...that is good.

And along with the arthritis you have, the disks are slowly getting smaller as they do with age(everything shrinks with age, doesn't it..except the medical bills).

But the last thing they added was a first for here...the lordotic curve in your neck is getting deeper, instead of straightening. Lordosis refers to that inward curve we have in our necks and it normally gets straighter as we age...yours is getting a bigger curve to it...and the same goes for your lower back too.

As for the hemangioma...I'm hoping Feelbad will come along and explain them...she had one in her actual spinal cord that had to be removed. They are benign and so can stay there unless they cause a problem with your spinal cord. It may hurt a lot but there is not a lot they can do for it as far as I know. Eventually, they will probably have to remove the damaged bone and fuse the area from either side.

Now your lumbar spine......the situation is somewhat the same but here, the vertebrae are much, much bigger but the cord is much smaller as so many nerves have peeled off and even the holes where the nerves go out to the body(foramina or neuroforamina)are twice as big as in the neck.

At L3-4 and L4-5, again you have that bulging disk that has bulged backwards enough to hit the thecal sac of the cord and is pressing on the "peel off" nerves on both sides....those side nerves can cause pain and/or numbness above and below the knees and the back inside of the calves. At L5-S1, the bulge is even worse and is hitting the fat that is around the vertebra, the thecal sac and both the nerves going out to the body. This would cause pain/numbness in the feet(top and bottom) and the outside aspects of the calves. And you have arthritis in the vertebrae all the way down. Although the nerves are being hit, it says the holes where those nerve go out are all open so the bulges may be like mine are...hitting the nerves outside of the canal area on the sides...hard to explain but picture a doughnut that had squished out to both the sides and back and it's hitting things all over the place. I've got the same thing and until they show it to you on the MRI, it's hard to picture...but disks can bulge anywhere around the circumference and the nerves come out from the back of the bone and wrap around to the front so they can be hit in lots of places.

As above, the disks show loss of height and "signal intensity"...think losing substance....like a shadow gets lighter as the disks shrink up they look lighter on the MRI.

And as I said above, your back is developing a deeper curve to it.

So I hope this helps you understand what is going on. The arthritis alone can cause tons of pain. The nerve compression in your lower back can cause pain, numbness, tingling, pins and needles...all sorts of stuff. They didn't put in what they classified the amount of compression as. If you see the words "minimal, mild, moderate, or severe" in the report, that is how the list the amount of compression to the nerves or the cord.

Oddly enough, the one thing that probably worries you the most is where the disk bulges are hitting the spinal cord and thecal sac. When that happens slowly over time, it is not a big problem and the cord can take a lot of compression. The normal cord is about 12mms...mine was down to 5-6mms at 4 different levels before I had surgery. It's only when it happens suddenly that you have a big problem. With time, as it worsens, you end up with problems walking and numbness anywhere from the level of compression on down as well as others.

Anatomy lesson over...questions?????

Jenny
Thank you Jenny for your response! It was so useful and has made me feel alot better now that I understand exactly what is going on!!! I do have severe pain in my neck and lower back from the accident I had on 9/6/11!!! I have weakness, tingling and numbness in my right arm/shoulder and weakness in my legs! I also had a MRI of my shoulder and as I had not rotator cuff tear it said it could exclude a partial tear of the bicep tendon! But all they suggested at this point is Physical Therapy for my shoulder! I can't even stand over the sink and wash dishes for long from the burning pain in the middle of my back!!! I take muscle relaxers and pain pills throughout the day! I have been out of work for 6 weeks and hoping the pain management (spine doctor) i just started seeing will help me get out of pain somehow. I did see a neurosurgeon who suggested I see the pain management doctor! I did one round of epidural steroid injections in the neck and in a few day he is doing the (facet joint injections) for the arthritis in my neck! We haven't discussed my lower back yet, but I'm sure he will be doing injections on my lower back as well! I have been getting chiropractic care, but unfortunately I dont think its helping much! As far as the hemangioma the surgeon said it is an incidental finding and it doesn't cause pain! I don't know if I believe that!!!! Thank you so much for your time and explanation I really appreciate it!!! I hope your surgery goes well and wish you good luck and a speedy recovery! Thanks Again! Joanne
soo sorry it has taken me so long to just get here, been tied up with another post and dealing with all my c spine crappy stuff too, but jen pretty much nailed it as far as what YOU would more than likely just be feeling from actually having ANYTHING that is simply even in or impacting bone, PAIN. usually like a more radiating/aching type? so your upper T, and since the bones are all interconnected, wrap around pain very easily could be generating this constant 'ache' there(it could also be simply following that T2 dermatome too which would wrap around, esp if anything is just 'central' in location when it comes to the spinal). and with, in MANY cases, only becasue this hemangioma just IS there 24/7, it can create a type of non stop 24/7 pain to have to deal with too. mine was inside my actual cord so it was generating the most INSANE types of 'perceptions of 'activity' going on that WAS also a non stop and 24/7 flippin nightmare(i had this totally insane 'prying" sensation like someone was litterally trying to pry off my shoulder blade on the R side,and a TON of real solid pressure pushing out from under that same blade as well. just sick). thankfully for you, this is in bone. sucky yes, but not nearly as bad as could be, trust me.

the one thing i WOULD hold off on til you can at least possibly also see a vascular specialist to get the actual angioma much better and more clearly defined is NO more chiro treatments up in THAT particular area at least since most hemangiomas just also can have the tendency to bleed(but that totally depnds upon how much vascular if any is feeding this too). the thing about hemangiomas is they just ARE a vascular lesion and in almost every case, they are also usually attached to what are called 'feeder vessels' too. this is what kind of 'keeps it alive' so to speak and filled with venous fed blood(you need to find out just 'what is "alive' in there or if this is/has kind of died off in some cases but would leave what IS a vascular congenital malfomation behind). and in your case, given this is in the actual bone marrow cavity, it 'could' just possibly be like 'leaching' its blood FROM that marrow too? just a thought considering this IS vascular in nature. angiomas ARE also venous and NOT arterially fed like an AVM would be(the AVM is the arterial counterpart to the V fed angioma). i din't see any sort of actual dimensions given as to haw large this is, only that it is anterior and inferior, meaning front and lower?

the hemangioma just being there at all in an actual vertebrae will make that particular vert just a bit more susceptable to possible fracture at some point too since this is NOT 'just' all solid bone? but that could happen wayyy down the road for you too esp since you just had an MVA and nothing happened to it then, so it sounds very stable anyways(plus T spine is pretty well protected unlike the highly susceptable to injury c spine. nothing really 'has its back' ya know?? but i DO definitely think the majority of what are the pretty standard for c spine issues are what IS the more impactful part of your report tho. the most prominant 'symptom", as i mentioned above for these in how they will 'present' or simply show themselves IS with more of an achey radiating out type of pain. have you ever tried ANY type of actual NSAIDS for that particular pain(you DO have a good level of inflammation going on just from having this in a place that it should not be as well)? that, just because it IS bone pain would be in my opinion anyway in having severe bone pain myself from something else, these meds just have a much more direct impact on THAT type of pain from most types of more 'boney" inflammation.

the one huge 'myth' about hemangiomas is that they do not cause pain(and "they" do not, themselves since there are no nerves, but there ARE vessels and vessels can generate their own pain too depending). BUT, it all really comes down to location location location. if this is impacting ANY actual nerves, or as in my case, my cord, or in the brain(the most common area for these to form, and what i had as a "cavernous hemangioma"), it all comes down more to where they are located and what they are impacting as to whether or not any given angioma will generate pain of any kind, or other off the wall insane symptoms too.

getting a more in depth look into the overall make up of yopur particular angioma really should be done. but if you end up with a much more aware and knowledgable type of NS, he may try and get this figured out FOR you too. but PAIN will usually be the most common and sometimes ONLY real symptom of even having one at all,esp within the spinal structures of bone. but given what ypou have going on up in your c spine seriously overrides anything that the angioma would or could actually impact or do, so i would seriously try and concentrate on that area right now and what needs to be done. the angioma is kind of a secondary thing that right now needs the pain better managed. there really is not a whole lot else that CAN be done for that part. i don't know if given the location of yours tho, they possibly 'could' sclerose it with a chemical and dissolve it in some form? but that too would depend very highly on any actual feeders attached to it too since if they ARE feeding it and if not able to be closed off, you cannot inject the needed sclerosing agent since it would also follow the vessels out as well which is NOT a good thing. otherwise, it will just 'sit there' and probably do nothing else actually TO you. alot of people have these in the verts,among other places, too and really do not have any other issues other than simply trying to keep that edge off the pain they can sometimes generate. i KNOW there are people on the back boards here too who have mentioned these also being 'found' in verts upon MRIs they have had. that may be helpful to read if you can find those particular posts by doing a search on 'hemangiomas" in THAT particular boards search?

but for now, your c spine is what really does need more attention. i hope this helped some at least. there are many other places you could have ended up having this that truely would/could make your life hell. hopefully you can find a good way to get this pain managed, and also figure out 'IT'S" actual 'make up of what is within your particular angioma too, just for a better chance in treating that particular pain in the most 'appropriate' ways. marcia
Thank you marcia for your reply I really appreciate it! I did see a neurosurgeon and he just said OH alot of people have them and its an incidental finding and doesn't cause any pain!!!! I find that hard to believe as I also have severe pain in my shoulder blade and shoulder itself! I am seeing a pain management doctor for the cervical issues and hope I can get this taken care of first!!! What type of doctor should I make an appointment for the Hemangioma??? Is it a specialist??? Thank you again so much! Joanne
quick question joanne. when they did both of thoese MRIs on your upper(the initial then T spine one) did they use a contrasting agent of some kind to better highlight esp the vascular components or was this esp T spine one done without any contrast? i can make a real difference in even what, within any hemangioma, simply gets seen or where the feeders(if any) actually are. for the most part, your NS is right in that soo many people DO end up with these lil suckers simply forming somewhere within the spinal processes and the cord/brain(within that CNS) too, but that is much more rare than within boney parts of spinal. these are actually formed while YOU are forming in utero for some insane reason. and there really is not a whole lot that even CAN be done, unless as jen stated, they ARE generating insanity like mine started too. but considering where yours just IS within that marrow, i would NOT really want to disturb THAT sucker unless something a bit more insane starts occuring. if and when they do your surgery which i am assuming would be hopefully ACDF, they WOULD be able to better visualize the hemangioma since it would almost have to be at least partially out of that vert, and also anterior too, unless it is extremely small, which IS better for you anyways.

have you ever tried what are lidocaine patches over the back area to see if it would stop at least the overall radiating from occuring? there little wonder patches have helped me sooo flippin much with so many areas of my pain that nothing else seems to even come close to touching. it 'could, tho yours is anterior, STILL help with what you are feeling in between your blades, under blades, and potentially also stop that wrap around pain as well. its just something that should at least be tried for PM considering how much of 'you' is being impacted and around the bones. tho they can be a bit spendy, even with most peoples co pays, if it actually works on ANY real pain, in my book, it IS money well spent. they can also be cut to cover smaller skin surface areas too so you do not have to use an entire patch to hit what sounds like a much smaller overall generator. these patches also should be running out on their patent here soon too since i was initially given these while in the rehab hosp post cord surgery and that was back in 2003. it would automatically make them much cheaper than they have been costing once they run their patent out and another drug co can simply also manu these too.

it is great that they tried and rule out your rotator cuff before deciding what pain was actually being generated by rotator issues, since the nerves FROM c spine at the lower end DO also run thru the shoulder levels and then downwards and eventually(with the c 6 thru T 1) hitting the fingers. tho T 1 only has 'some' fine motor function and NO actual sensory components in the hand level. i DID have some really messed up damage in my rotator cuff with my very top run across the shoulder to the top of that humorus which is also innervated by the c 5 with sensory, and we NEVER ever checked out my rotator back then so it was simply 'assumed' that what I was feeling WAS generated by ONLY c spine crap. it was not til that very top tendon simply snapped in half on me one fine morning that i HAD TO have my immediate loss of ROM and any damage defined in 07 that we DID find out just how much real impact 'my' particular rotator had on my pain and ROM loss. then of course it was too late to 'undo" the two seperate c spine surgeries(the initial ACDF in 02 followed only 9 months later by a plate and screw placement when i only fused one endplate). so that is a good thing that they did that one MRI on yours, trust me. but i am a bit confused tho while reading thru THAT part where you mentioned a 'possible' torn bicep tendon or something to do with your bicep, if that IS or is NOT actually damaged(if i remember right that one is called the inferior supraspinatus(that one in me was also tearing trying to compensate for the ongoing bigger tear in the one above it and i had one heck of a very sore bicep as well too, just did NOT know why til that MRI showed the connection. that also had to be sewen during my surgery. the one above it is what i snapped which is the 'supraspinatus)? it was just kind of confusing to me while reading that as to whether it IS or is NOT torn or an ongoing tearing is taking place? you most definitely CAN have both going on at the very same time like i did tho with rotator issues AND c spine crap. i simply did not realize that then and my NS never ever mentioned that either. we DID end up having another surgery on my rotator cuff to repair a ton of damage in there tho.

i am just wondering where all of your spinal damage/impact came from tho. you just DO have alot up top and within that lumbar too? i know i played alot of sports that also trashed, or "began' MY rotator crap anfd a ton of 'accident prone' types of stupid things that kept me and my dad running to many an ER run that did impact me mostly from ongoing trauma. i too also had an MVA but only X rays were taken then so nothing really 'in depth' actually showed itself then(this was like 87-88?). my pain and radiculopathic symptoms that you are also now having, really did not flare up in me til around 2000 or so? but i had spent many many years working as a ff/emt too which seriously messed up alot as far as spinal goes. i am only 5'2" and tiny frame but i could lift more than my own wieght which was back then about 115lbs. i did lumbar damage, but mostly c spine. finding out i even HAD that cavernoma inside my cord was one of those lil 'incidental findings' that no one wants to have. my cord amp is only around 10mms and this 'glob" was taking up a TON of my overall cordspace right AT the c 8 nerve level. it was approx 4x6x8mms in size.

the overall knowledge that soo many different NSs simply do NOT have enough experience in dealing with led me thru THREE seperate opinions,which two of were totally different from each other as far as what this glob ment for ME? i ended up going to the u of mn here which thankfully was very close by to get a rea honest to god 'experienced" opinion that did change EVERYTHING for me. this is also when i found out i had an active bleeder in there and that it had actually already bled at least once even before that first ever MRI was done in 01. lovely.

luckily for you, this hemangioma you have IN the marrow cavity, i really do think it willmore than likely just 'be there', but will not react like the cavernous hemangioma type. getting a good CONTRASTED type of MRI would show the vascular levels of what is in thai in the best way tho. but i think for the most part, pain will be the biggger issue just considering its location. so getting to a good pain management doc/clinic seriously would probably help the most depending upon what the NS decides needs surgical intervention too. but DO see if ANY doc you are seeing hasat least one or two samples of the lido patches. i really do think, just knowing what these have helped ME with that they could really take the edges off of THAT particular pain anyways. they are always worth a good shot just to see. i now use them on several bad areas and i have to say, they DO beat my narcotics by a flippin mile in certain areas.

i will get back here with some stuff regarding the c spine findings hopefully tomorrow. as far as spinal deformity goes at the cord level? when the areas of compression are 'longer' and the pressure is much more "spread out like jens was, it is a bit less impactful overall since you do not have a smaller ,and usually a bit 'sharper' direct impact INTO a spot on the cord. but if that deformity of the cord has that very direct area of impact going on, than it DOES become more impactful because you do not have the luxury of wieght being displced over a longer/wider surface area? do ya know what i mean?

a good overall neuro eval should be able to tell just what is being impacted by virtue of the 'stimulate/response" type of testing they just do to tell impact. just how ARE your actual reflexes, normal(subtle bounce when the area right below the kneecap gets tapped with that lil hammer) or very 'brisk/rapid type of more pronounced type of bounce out? the more 'brisk or sudden snap out you have usually just indicates that at the very least, your upper motor neurons are being impacted much more directly. but having both the lumbar AND c spine.depending upon what governs what,can also skew the this type of test. but even when other L spine issue are going on, since the cord generally stops itself around T 12, there IS NO actual cord that runs down THAT far, so it can be much easier to tell true cord impact/reflex from upper motor neurons that are ONLY within our cords anyways. the end of our cord where it terminates is called "the conus'. it 'usually" stops around T 12 but there also CAN be in each individual,a few levels above that or below it too. but that t 12 is kind of the 'norm' for most. so what you get left dealing with after that is whole lot of nerves that innervate the legs, with no actual cord, but the thecal sac containing that needed CSF still runs down to usually the sacral level anyways.

gotta fly right now. but will be back joanne. marcia
Hi Marcia: Just posted something but don't know where it went! It didnt come on the boards! I wanted to let you know that I have am still having severe pain in my cervical area as well as shoulder/arm and elblow it is ridiculous! This pain just doesn't stop!!! I am getting very agitated as well as depressed! I don't know if I mentioned to you that I have psoriatic arthrits and take Enbrel, methotrexate, folic acid and prednisone 5mg on a daily basis! The problem is every doctor seems to get tunnel vision when they treat me because as soon as they find out I have PsA it all has to do with that!!! How do I get them to look past that!!! I also forgot to mention I have had vaginal bleeding for two months can that me from the hemangioma!!!! They all say the hemangioma is not causing my pain but how do they know that for sure!!! They only did a regular MRI of my neck when they seen the hemangioma!! Should I ask for an MRI with contrast so then can see it better???? Also, I have another appointment scheduled with the orthopedic surgeon who didn't even care that the MRI said cannot exclude a partial tear of the bicep tendon and just gave me a shot of cortisone in my shoulder and told me to Physical therapy! It is so painful I can hardly use my arm!!! I can't work because I can't type!!! These doctors just don't care!!! Im sick of the pain!!! I did take you advice and put the lidoderm patches on last night it took the edge off at least! I have all kinds of medications and patches! I have lidoderm patches, flector patches and pennsaid gel!!!! I would like to think that I am going to be able to work again but that seems so far away at this point!!! If I do housework whatever it is I pay dearly for doing it (end up in bed from the pain) I am only 44 years old and feel like 75! I am also due for my second set of injections (facet injections in the neck) should I ask the spine specialist if there is something he can do for the hemangioma??????? And what exactly should I ask this orthopedic surgeon about the possible partial tear of the bicep tendon! Is there another test they take to see if it actually torn???? I really thank you for all of your help you have given me more information than the doctors!!!! I can't thank you enough! Joanne
i have been scratchin my head over why in gods name, when your neurosurgeon actually ordered that T spine MRI to(i am assuming) actually get that much more closer and detailed look at the hemangioma, why he failed to simply also order what is a pretty standard thing here esp with ANY type of 'vascular' involvement needing definition, a contrasting agent of ANY kind at all??? it really IS very basic standard protocal for any vascular malformation definition.

i had to go back theu all of MY stuff i researched on my cavernoma and also did a bit more in depth looking again yesterday to see what if anything has changed in what the needs are, what can produce from hemangiomas and also ANY actual 'treatment options'. some things are now more recommended when the malf is either generating insane symptoms for the patient or 'high levels of pain' as well. what i mentioned in the other post about doing the sclerosing of the angioma IS pretty much kind of standard now. but until that angioma truely gets defined down to the actual 'feeder vessels with a good scan WITH contrast, it cannot be done since they wont know if the alcohol/ethenol they use to try and kill this off will also follow into the feeders and or the draining vessels too.

the one thing too here they have to do just becasue a lowley MRI report that quite honestly from just my own experiences(have had 20 now) and other people here and people i know personally with any real findings that just have had "not shown up"(but WERE there and found usually during the dang surgery, or showed up on deeper types of scans later) esp on basic MRI, that hemangioma just 'could be more than venous fed or 'just' an hemangioma only that is made up of only veins/feeders and draining vessels. the bigger reason i DO think you need the make up of that 'hemangioma" better defined is what I had stated in MY MRI about MY vascular malf in my cord that was WRONG, but the interpretting rad who DID my actual report stated it totally was?
what my original first ever MRI done(c spine for herniated disc) that was the one that found my cavernoma in my cord actually stated without a flippin doubt that i actually had the very dreaded AVM(arteriovenous malformation, meaning BOTH major arteries but in this in a tanlged mass and "some' veins) in my cord and NOT 'just' the venous fed cavernoma it was. it took my first NS sending me for the 'defining' angiogram to see if that sucker would simply 'light up' once they injected contrast directly into an actual artery at the femoral one in the groin and NOT the usual route when they inject at the bend in the arm into a vein would do. if contrast is directly injected into the artery, if there is ANY light up on that screen they use to see all this, then there just IS some level of arterially fed component in there which IS a much higher risk for bleed, and more akin to what an aneurysm would be in my cord with just having the very much higher pressure that arteries carry vs veins? it had absolutely NO light up at all, and that is when the interventional neuroradiologist(these guys do the angios and also treat insane types of vascular issues too like coiling my aneuryam in my brain in 05? they ARE the ones to see for vascular crap. what they do from inside vessels only is absolutely amazing actually)turned to me and said it was NOT what my MRI had stated or the interpreting radiolgist had decided it was, but the cavernous hemangioma instead. i stupidly thought i was 'out of the woods', not by a longshot as i found out when i hit the U of MN and an amazingly knowledgable NS who was head of NS who had a ton of experience(over 30 years) in dealing with what i just happened to have. he was also my third opinion.

i really do think you need some level of actual angiogram done to ID the make up of this, just because your report does not state this as it IS most definitely a hemangioma, it states it "is consistant with a focal hemangioma of the bone" period. the only other way to truely tell from the outside is what the mayo actually recommends as a "CT angiography". this would show alot as far as what the heck this just is made up of, the feeders that are attached to it and alot of more detailed info too. a CT can also show actual bone itself sooo much more clearly than MRI too. what may not have shown up on an MRI you had done, esp post MVA may show up on CT. there just 'could' be a small hairline fracture within this vert that has the angioma in it that would not always show itself well upon an MRI(did you have that T pain BEFORE the MVA too or ONLY post MVA? that too does matter). there just is sooo much that MRI cannot always pick up or even see by virtue of the type of actual scanner used. and the same goes for CT too, these are ONLY scans of an area and NOT at all and actual kodak moment like a picture. so what one scan may miss, the other may also pick up on. i have had this occer with me just this past year with MRI and CT. two really different things as far as findings go. using both scans together would help you i think in the best ways right now. and most DEFINITELY with contrast.

i would also take a good read thru the mayos site only because out of EVERY single site i looked at info from, that mayo one was the ONLY one that actually stated that hemangiomas CAN cause pain, go figure. but it DOES soo much come down to the actual location of these suckers too. there is also a very huge blood supply that runs not just thru and around the cord itself but wraps aropund the spinal column verts too. if you just lok up 'blood supply to spinal column " then hit images, you will run across alot of the actual spinal cord blood supply initially, but then there ARE other images/graphics that actually show just how heavily vascularized our columns are too and at every single level. this just is usually where the 'feeders" can come from TO any given hemangioma. or it can also draw as in your case, the actual marrow or pull from our cords as well. this really just needs better definition to even know for certain just what you do have(probably IS hemangioma, but your NS does not 'know that' 100% either) it is only 'assumed til confirmed, ya know?

at the very least, i would see if he could just refer you to a vascular surgeon for eval and a send for the CT angiogrphy or even directly to the interventional neuro rad like mine did just to really know for certain so it 'can' possibly be taken out of circulation and not have to be 'dug out'(not a 'have to, just an option) of the vert if it should happen to bleed. anything vascular can bleed or with these, they can also engorge with blood and generate more pain just FROM that 'engorgement which enlarges them from the inside vessels. it would impact the bone more if it does this. just 'do' as much possible research on this sucker so YOU KNOW what it is you are dealing with. this simply allows any patient to simply ask the 'best' questions of their specialists and gives YOU much more confidence in asking about certain tests that may help you too. if you have to, print off the most pertinent stuff so you can show what YOUR findings were as well. they do take a patient a bit more seriously whan they take the time to really want to find answers for their symptoms/conditions too. that has been my experience anyways with six surgeons who all did surgeries on me. but DO get some form of actual contrasted scn here. i just cannot believe an actual NS would be that stupid,seriousaly. maybe he forgot to order it with that new T MRI or something, but he HAS to know better than that, ya know?

unfortunetly i gotta go now. got too much on my plate agin today. just wanted to touch base with some info tho. but i will be back soon, marcia
Hi Marcia:

I am definitely going to mention to the spine specialist on Monday before my injections on possibly looking further into the hemangioma and see if he can refer me for a CT with contrast or angiogram to look further into it!!!! If he can't, I will ask him to refer me to a physician who can help me look into this further! I went to the orthopedic surgeon for a follow up visit for my arm pain and weakness which I mentioned my MRI of my shoulder showed a possible partial tear of the bicep tendon!!! He scheduled me for surgery on December 12, 2011 to do arthroscopic surgery and see what the heck is really going on in there and fix bicep tendon! While I was there he gave me another cortisone injection in my elbow which is so sore today!!! Im hoping with the steroid injections in my back and the shoulder surgery I will eventually be able to get back to work after the new year!!! That's if all goes well with everything! As far as the Hemangioma I will look further into it to see if its affecting my bone and causing this pain in my spine!!! Thanks again for all your help!!! Its funny, these doctors make it like this hemangioma is nothing and it can't be symtomatic!!! I think they just don't know enough about them and that what your told!!!! Hope to talk to you soon!!! Joanne
the thing here is joanne, a ton of people just DO have what you have and they never ever actually know it, or feel it. it isn't even known about til its found upon autopsy in most, unless of course thay have some type of scan that shows it. some just are very 'silent' while others(and this can be part of the individiual angiomas own make up too), really CAN raise holy heck just by the size and what the actual location simply is too(like i said befiore, that actual location of these IS what will usually make them known or not known or felt by anyone who has one). so alot of NSs just DO tend to blow these off unless the PATIENT themselves keeps them 'on it' and explains exacting areas of pain and symptoms to them. when everything just 'fits" in 'their' heads, it will make YOU and your angioma much more believable that it IS terrorizing a particular body area. so do NOT let up on this joanne, keep that angioma alive during conversations and DO ask to be referred for much more detailed testing to see what THIS angioma is made up of and how best to treat it, or your pain. but just so you know, no matter what you do here, that particular vert will pretty much always be a but more weaker structuarlly than your others just would. but it IS at least IN that T level and not higher up in the c level.

thats great that he is at least going to scope that shoulder out and actually see what areas THAT part can be contributing to your overall pain, since from my experience, i am sure that SOMETHING. esp a tear in any of those tendon just WILL add to your pain(in your job, along with everyday stuff we just "do', its just a ton of ongoing wear and tear, and in your case, also repetitive motion damage usually). this will also take one area out of the picture now too once you heal. like me, you just have a few different potential and definitive pain generators going on that in some cases, tend to, or just 'can' also cover areas that can simply 'mimic' as the initial pain generator when its not, so i am thrilled he finally listened to you joanne, really. him doing that scope really is not a huge deal either(usually called a 'minimumally invasive surgery). just a series of smaller incisions big enough to get that scope thru to look around(it also takes wonderful picutures inside our rotator cuffs too. i have six on a page my ortho took in mine that show the "bad' areas, kinda cool actualy). they can also fix certain types of tears/problems right thru that scope using lil microtools too. i had to have a very lg incision(from front to back over top of shoulder), and smaller scope holes with my rotator surgery only because he had to fix that fully snapped one at the top and also had to use anchor pins into my very top of my shoulder/humorus bone too just to keep that supra from moving at all til healed/PT. so THAT kind of crap is what happens only when someone does NOT get what starts out as only a smaller repairable tear fixed. it just keeps a going on and on til fully torn. so this IS a good thing he is doing.
let me tell ya hon, just getting ANY of those needed and heavily used rotator tendons actually sewen back up BEFORE they just will eventually snap with ongoing use is the BEST possible thing to do NOW to 'prevent' what i went thru and not 'knowing' things were that bad TIL full "snappage" and had to actually drop what i had been picking up since as soon as that 'lift" tendon/ROM went on me, so did my ability to just continue that lift up i HAD been doing when it happened. it was THAT sudden, then oh the flippin pain. so i totally feel he is doing the best possible thing here for you in hopefully finding ANY areas of tearing, that if not simply sewen back together will never heal on their own and just keep tearing til they snap. this scoping just sounds like a seriously great plan to me.

once THAT area gets fully defined as what is involved which does not always show its 'true levels' of ongoing wear and tear in all areas on MRI or what i had as both bursitus and tendonitits too will SEE it with a pair of trained eyes INSIDE. can't beat that. i still do think that at least some of your more upper c spine crap is also playing a part in that shoulder pain too simply by how the innervation runs out FROM there and down your arm. most rotator crap, and this is what my ortho told me, does NOT usually impact the lower arms'/hands in the same type of radiculopathic ways that the spinal nerves do. so what IS going on further down your arm i DO think IS c spine. you have both what sounds like fine motor impact and sensory impact and they do NOT play out on the very same nerves with each component. c spine nerves are VERY different than the T on down nerves in what they carry as motor(muscle or fine muscle in the fingers) and sensory/pain touch,and yet both are on the very same only ONE nerve at each level on each side compared to having two seperate 1 sensory and 1 motor nerves in the rest of each of the spinal levels. very crazy in how what innervates what ONLY in that c spine. if you really want to ever actually read how that area runs, simply look up what is called 'our peripheral nervous system'. that does explain the more insane ways our c spines are and actually innervate down to our fingers with movment and touch.

but simply by having this surgery done hon, it takes out at least one potential generator to have to deal with. after that gets done, it will be MUCH easier for all of your docs to better understand just what areas are generating what in you. and when you have multi possibles like i did and you do, that IS a biggie. it just narrows down OTHER possibles. healing wont take as long either when there is not a huge tear to have to deal with. tho at least 'some' level of real good PT will be required til that one tendon at least, gets back to the norm ROMS. i guess we will just have to wait and see what happens post op now. but iam glad you spoke up to him and he listened too. that is usually the hardest part in dealing with most docs, esp the 'specialists. good luck with that. but also DO see if they can get that angioma figured out using the 'appropriate' type of scan AND the contrast they seemed to forget WAS essential here too? seeing either a vascular surgeon or just being referred to that intervenbtional neurorad who can also do this type of angiography would help. its just that onec you have even that CT angiography, you would also need someone like this to actually even explain the findings to you too. i just don't know how good at THAT part your particular NS actually is. unles his actual practice has an NS who specializes in the more 'vascular issues" that can require spinal or brain surgeries like i did to fix? if they do, then that would be the surgeon/doc to consult with. otherwise, you DO have the other options too here. marcia
Hi Marcia:

Just an update had the cervical facet injections yesterday (8) in total and just feeling real sore today so really don't know if it was successful at this point!!! Im hoping it works so at least one problem will be out of the way and I can focus on the shoulder and hemangioma! I still think this hemangioma is causing pain in my spine (where exactly is the T2 is that on top of my spine) it feels like a deep aching and buring pain in my spine! I spoke to the spine specialist and he is going to to refer me to a vascular doctor to check it out!!! He really feels that it isnt causing me my pain but he said if I want to further check it out he will refer me to someone! I still have another set of injections to do on my neck and we didnt even get to the lumbar spine yet! Which the
S1 joint really bothers me from the Psoratic Arthritis! Of course I still have the right arm weakness and pain because the shoulder hasnt been addresed yet. Like I said the surgery is scheduled for 12/9! How bad is the surgery? How long do you usually stay in a sling due to christmas being so close???? But I have to take care of it because I need the use of my right arm so I will have to have my family pitch in for the christmas events!! I guess there will be alot of gift cards this year!!! LOL!!! I am hoping that I will get through all of these medical issues and treatments and go back to work part time sometime in January, 2012. I hope I will be able to sit in my chair for 8 hours and type as that is such a big worry for me!!!! I am only 44 and don't want to be on SSD so soon! I know I have Psoratic Arthritis and thats a story in itself but I don't want to give up and be homebound! It does get very depressing which nobody can really understand!!! I have pain on petty much a daily basis and the winter is coming which means even more stiff joints!!! With psoriatic arthrits it waxes and wanes it could be your ankle one day your elbow the next, your hands the next and doesn't stay in one place all the time!!! Since diagnosis three years ago my life has changed tremendously. I use to be able to clean my house in three hours in one day now it takes me a whole week to just to get things done!!! The fatigue associated with it also takes a toll on you since it makes you so tired most of the time needing a nap! So this automobile accident didn't do any justice for me it just made all of my prior medical issues worse! Thanks for listening and thank you for all of your insight! You have given me more advise than the doctors! Thank you so much! Hope to talk to you soon and hope your feeling better yourself!!! Joanne
sorry it has taken me awhile to get back here joanne. things have not been the greatest.

the ONE huge thing that the MVA did for you, tho it does suck to have to deal with, is make that hemangioma simply 'known' at all, ya know? my c spine had "something" just not right that was very similar to what my hubby had gone thru like five years before with a herniated disc at c 5-6, so i knew that i probably had done the same thing, just based on the radiculopathic symptoms i was then having too. so i got sent for that very needed MRI too which revealed MY lil glob inside my cord ONLY then. it did explain alot. but because it had already bled at least once and was considered "an active bleeder' timing WAS critical for me and what i needed done. so not every 'seemingly bad thing' is ALWAYS totally 'bad. if mine had not gotten found when it did and certain other things also occuring that involved clueless on hemangioma NSs too, i never would have found my biggest and best "expert' at the U of MN before he would have retired in 06. i AM thankful, believe me. and before he retired, he DID also, based on only a 'hunch' send me for the MRA and 3T scan that found my anuerysm too. but trying to even begin to replace that man has been a nightmare. that part sucks, but he was there when things were hitting the fan for me and thats what mattered ALOT then or i could be paralyzed right now if i had NOT sought out just one more opinion and at a facility that i already had trust in too.

honestly, i so do believe that for whatever reasons, things DO just 'go' for us in our lives the way they are supposed to, even the really sucky parts. it all has its reasons that DO impact our lives and changes us in ways as well. sometimes like "finding" certain things, it is usually a 'good thing". esp things that can cause MORE harm if they are not known about til 'they have some type of 'presenting event' attatched to them like mine did and also would have again as well.

i am glad to hear that despite your NSs feelings he STILL is referring you to at least someone who has a much better and clearer understanding of pretty much anything vascular. many docs/specialists who feel that way do not bother to even do what yours is doing in many cases, so that IS a huge plus for you hon, seriously. many NSs will "only' go with their own opinion and at times VERY limited experience with stuff like this when the patient DOES resuire at least "some' type of help or intervention with certain anomolies.getting THAT opinion will help. he or she may want to do nothing or something, it really depends upon what "they see' and feel about your angioma. sometimes, when these are simply located in the boney areas within the spine, it is best to leave things alone and do pain management. but depending upon just how much pain and potential they have in some rarer cases when in bone to bleed(most "in bone' do not), that really would dictate any possible options(this usually depends more upon overall size and just what IS feeding it too). the thing ya have to remember with where this just is joanne is no matter what they do there, that bone area STILL has an 'issue', so you may not be able to even reduce that pain level, or maybe just 'some', or maybe be pain free too. its kind of a crapshoot, just like with injections and or other potential 'fixes' too. but hopefully the vasc doc will have more info and options for you to at least consider. but that particular vert will also always be a bit weaker too. its just the nature of bone when 'something' is IN it, and makes it not a 'solid' piece of bone anymore. but they DO really need to ID the make up of your particular hemangioma too. and they will more than likely either do a contrasted MRI on this or even an angio to see if there just is ANY possible light up within that angioma at all. knowing what anything actually 'consists of' is better for possible treatment options too. they could also possibly try and sclerose this with a form of alcohol, but doing that really depends on where and how lg the feeders are since it can run thru that vessel of the overall inner vascular pressure is not high/strong enough to prevent whats called a "reflux, or backflow? but that is something to discuss with the vasc doc among other things too.

just DO research all possible treatment options and make a good list of questions for this doc when you finally get in to see him or her too. i had three notebook pages of flippin questions when i saw my third wonderful opinion. and he took the time to answer every single one too. THATS a great specialist. but make CERTAIN that the shoulder surgery gets done FIRST before ever consenting to anything(if you can even get in to see the vasc doc this quickly) just so you will know for certain what pains/symptoms you have been suffering are coming from where in there. since that rotator cuff as a whole along with all the many tendons, ligaments joints and muscle are also interconnected to your ribcage too, its kind of the same type of "problem' when you have c spine issues but the tendons also run right straight thru along with a majority of the c spine nerves right thru that same rotator area? anything simply 'wrong' that runs thru another area where you are having symptoms just has that potential to not be where you may THINK it is. so getting that shoulder taken care of, healed and PTed and THEN really try and feel what is 'left over' to still deal with will help alot in simply telling your NS and the ortho who will be doing that surgery too just what pain could be from other potential sources. once even ONE pain generator gets taken out of the picture the reast can just be that much more clearly 'tracked back' to its real underlying sources. with what has been found on your shoulder MRI i really would not think your 'fix' will be too overly invasive or the healing time and PT anything like what occurs when you totally snap a tendon like i did. that is a totally different type of more in depth surgery when you just have much more repairs and damage to fix and heal from. if that one area is the 'only' real problem he finds in there, i think you will rebound back pretty quickly.

in my case with my rotator, some of what we 'assumed' was my herniated c 6-7(and some other levels of crap also found in there) really WAS in reality stemming from the mess of shredded and overly worn and torn tendons among other things in that R shoulder where MY most major symptoms also were from that c spine herniation. i just did not have a flippin clue how badly i had actually injured that shoulder many years before while lifting wieghts to just stay in shape for my job(i healed,and moved on). but i DID sure have some strange burning in my bicep and up top ON my shoulder bone whenver i over lifted. just never ever gave that shoulder a thought really. and then when that MRI was done on my c spine, everything else was kinda out the wondow as far as being looked at as fully as it should have been. i was too busy getting surgeries on my c spine and still freakin out about my cavernoma in my cord to even THINK about a lil 'shoulder' possibility. once that top tendon just snapped in half on me in 07,THEN it got ALOT of attention,lol and was found to be a real big mess in there as well. but i DO think you are on the totally right track here so far in what you have in place joanne, so thats great.

how realistically "long' anyone is going to have to be slinged or their own healing timeframe will go is usually more dependant upon just exactly what that surgeon needs to actually 'do' in any given rotator surgery. so i really can't give you a timeframe there, sorry. but if you are having this done THAT close to christmas, i most definitely would try and get as much help as possible just so you do NOT end up doing things you should not be doing til certain phases of healing take place. most surgeries where problems arise, are usually due more to the patient doing too much too early, esp when there just ARE alot of things to get done and they just 'feel' soo much better? so be careful and watch yourself with THAT one,K? you do NOT at all want to have to have that surgeon go back in to repeair something because it was simply overused before it was rehabbed back properly. just be prepared joanne and you should be fine. incase yopu have not yet seen this, there is finally a good rotator cuff forum right above here in the "R" section. it does have some good info on it. they did not have this when i had mine so we were posting up in the general section? but give it a looksee for YOUR specific problem and see who can give you some more direct types of info there. just a thought. marcia
JoAnne.. we have some similarities going on so I wanted to comment. I'd also like to ask Marcia a question about spinal cord tumors but I'll do that in a new post as to not steal your thread.

If this MVA was not your fault, I sure hope you've hired an attorney. Since you do have pre-existing condition(s) I wouldn't get too excited about covering your medical costs, lost wages, etc. as that get's tricky. Your atty would advise you. You may have medpay on your own insurance that may help with your medical bills (mine was a whimpy thousand dollars but I do carry min covg liability). I had to ask, the ins didn't offer it to me when I informed them of my accident. Actually, the chiro said they would pay it, and they did.

I was in MVA in 2007 and also had some prior back pain. They found a meningioma on my spinal cord via MRI, and a spondylolisthesis. The spondy was at a grade 2 (rated 1-4 -maybe 5, the latter being death from a broken spinal cord). Some gave me the ho-hum impression it wasn't so bad, others acted like it should cause horrendous pain.

My issue, MUCH LIKE YOURS, became "is the pain from the spinal cord tumor or is it from the spondy?" Various drs (ortho's. spine specialists and neuro) had conflicting opinions leaving me, beside myself. It quickly got to a point where I didn't care what caused the pain, someone just make it stop. I seriously contemplated trying to buy street drugs.

Most didnt want to touch the meningioma, then there was the Happy OSU neurologist who scheduled me for surgery in 5 days saying it MUST come out. Thankfully he commented he didn't see anything wrong with my lower lumbar (the spondy that had been seen/dx by [I]everyone else [/I]I'd seen prior) so I chickened out, denied the surgery, and found someone else. (I'm still shocked he missed the spondy, geez.)

My new neuro said 'wait and see' on the meningioma but we went fwd with a lower lumbar (L5-S1) spinal fusion Dec 2009. I've had VERY LITTLE pain (almost none) since that surgery so it must not have been the meningioma. I am supposed to have the tumor MRI'd annually to keep an eye on any growth. For the longest time I wanted it out, even if it wsan't the exact source of pain just so it couldn't sneak up on me later. I'd advise you to know the dermatome areas and symptoms that are affected by the location of your hemangioma so you would never procrastinate seeing a Dr for something like [I]tingling[/I] or [I]pins and needles[/I] etc. And also consider technology is getting more advanced by the day, they may be able to wipe it out with an aerosol tomorrow :)

Dr. George Jallo (John Hopkins) will look at your MRI (online) and advise you on the tumor. He's not shoddy for doing so online (free), he's THAT dedicated.

Be careful though jumping Dr to Dr. Find one you are comfortable with but know you will always find one that will do things you WANT that may not always be the best thing for you. Surgery is too often bad news. While mine has been a total success (thus far), so many people are left with constant nerve pain, numbness, tingling, etc.. I've been where you are, trusting them -the professionals- and hardly bearing the pain... it is complicated but hang in there.

I had bilateral facet joint epidurals just prior to my fusion. I hear those can also be used as a dx tool. Not sure how.. thought you might find out if they're using yours to control pain and/or dx. I think mine was both.

I really hope you feel better soon.. My heart broke when I read your post as it brought back so many memories of my accident, the pain, and fuss with Drs, specialists, etc.. best of luck to you.. get well soon.
Thank you for your reply its conforting to read when people try understand what your going through! I had my automobile accident on 9/6/11 (rear ended) stopped at a red light totally unexpected! I did thank goodness have great automobile insurance and all of my medical expenses have been paid through no-fault and due to have shoulder surgery on 12/12/11 partially torn bicep tendon tear!!! That's only one problem fixed I still have my neck issues which is torture C3-4, C4-5, C5-6 all bulging and impinging on the spinal cord as well as the Hemangioma on the T2 vertebral body showing abnormal bone marrow signal intensity! But, every doctor so far I have seen all say thats not the problem or where my pain is coming from! They seem so sure as I have my doubts! Not one doctor has even suggested to take a CT scan to see the size, exact location but there fast to make a diagnosis as thats not causing my pain!!!! I have had 2 sets of injections so far and still in pain!!! I should mention to you that I have psoriatic arthritis and have been in remission for three years until I had this accident which made it flare from the trauma! I have not been able to work since the accident and don't know whats going to happen for the future. I was a legal secretary and typed all day and these days with all this pain I don't know if and when Ill be able to return! My lumbar spine is just as bad with L3-4, L4-5, L5-S1 all bulging and impinging on the nerve roots. I am just a complete mess at this point! I recently just developed pustular psoriasis and going to see a doctor today as its now on my face and all I day is itch all day! I don't know if that came out because of the steroid injections?????? I thank you for giving me the name of the doctor as I am seriously going to consider taking the trip if he can help me!!! I am only 44 years old and feel like Im 90!!! The doctors just don't get it or they just don't care your only a number or your just complaining! I am on pain medication but that only masks the problem it doesn't fix it. I also can't thank Marcia enough on the boards as she has given me more information than a doctor has!!! I am not going to give up and will find a doctor willing to help me with the Hemangioma and the neck and back pain!!! Thank you so much for your post! Joanne





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