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Pain between shoulder blades

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I had an MRI of my thoracic spine performed in 2008 due to constant (r) arm pain and pain between my shoulder blades.

I would like to know what the findings on my report means.

The findings are as follows:

"At T3-4 there are (r) lateral endplate osteophytes and a (r) Para central extending to proximal (r) lateral broad-based disc protrusion which deforms the (r) anterior aspect of the thecal sac and flattens the (r) anterior aspect of the cord and narrows the right neural foramen. There are also some bony degenerative changes associated with this."

I am in terrible pain on a daily basis. I was told by my neurosurgeon that due to the location of the injury on my spine, surgery is not an option unless it's a matter of life and death.

I have recently developed numbness on the (l) side of my back and the doctor has ordered another MRI to see if the condition has worsened.

What exactly do the findings mean and why is the injury causing so much pain?

Category: Neurosurgeon

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Category: Spine Surgeon
Dr. Goutham Cugati is online now

Expert:  Dr. Goutham Cugati replied 4 Days.


Thank you for asking your query at DoctorSpring.

You have mentioned that, in 2008 you had constant (r) arm pain and pain between my shoulder blades. And now again you have terrible pain. I assume that the present pain is also in the same location.

The MRI report finding mean that at the level of third and fourth thoracic vertebrae (which corresponds to the upper region in-between your shoulder blades), there are changes in the bone and the disc in-between them which is slightly pressing on the spinal cord and the nerve at that level especially on the right side.

These changes you should have got probably due to the fall, which has slowly progressed over years to give you pain.When there is compression or pressure on the nerve root (which comes out of the spinal cord at this level), you can have pain and numbness of that particular region. As the neurosurgeon has rightly pointed out nobody would operate at this level unless the problem is very major.

As your problems have worsened one would like to know whether the previous problem in your spine has become any bad. That's the reason another MRI would be required. If the present MRI shows only marginal changes then they might put you on medications. So the bottom line is Surgery is NOT the first or second option. I would put it much later on the list. Proper pain management is essential and you might wan't to consult pain medicine expert. With some Physiotherapy and Pain medication I believe the pain can be best controlled.

with regards,

Dr Goutham Cugati

Consultant Neurosurgeon

Dr. Goutham Cugati
Category: Spine Surgeon
Residency: Neurosurgery, the Post-Graduate Institute of Neurological Surgery, Dr. Achanta Lakshmipathi Neuro surgical Center, VHS Hospital, Chennai, 2011

Postgraduate in Neurosugery: DNB, National Board of Examinations,
Part 1 - 2008, Part 2 -  2010

Medical School: Bachelor of Medicine, Bachelor of Surgery, JSS Medical College, 2004
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