My CT - curious on everyone's take
 

Hi folks - me again. I wanted to post an image of my latest CT scan results to allow people to comment on this image compared to their own. Trying to see if this is similar, better, or much worse than others who ended up having ADR. My surgeon did tell me that my disc is so collapsed that I almost don't qualify for ADR surgery but I really haven't seen other people's images to have something to compare to. You can also see some vacuum phenomenon in there (black spot) where gas has built up.

Let me know what you think. Does this look bad compared to what you've seen? My surgeon tells me this will definitely need surgical intervention sometime during my lifetime - trying to figure out if that time is now...

My L5/S1 still has normal disc height or possible mild loss of disc height but I have read other stories once it gets bone on bone that a autofuse can happen and the pain ends up going away.

Looks like your real close to that but also looks like your L5/S1 maybe out of alignment as well. Of course I am no doctor.

Since your involved in the study and getting one of the latest and greatest disc think your decision is appropriate.

Thanks longroad. Are you saying that your disc height is pretty normal yet you are still in a lot of pain? I'm wondering if the actual height really has no impact on amount of pain experienced. I would think the less cushion you have, the more bone-on-bone would cause more pain...

In addition to having lost disk height, it looks like your vertebral bone is being to react to the overload. It seems like the bone is denser immediately next to where the disk should be. That's a pretty bad sign showing either very high loads or very long times. I'd say your bones are telling you that you can expect surgery at some point in your future

What you see there is a lot of powerful contraindications to adr at l5s1...

Get second opinions... your facets are likely shot.. remobilise that arthritic joint and u ask for trouble.

Some surgeons are more aggressive with adr than others... some refuse to fuse.

Thanks all. Hooch - can you elaborate a little bit on why you feel ADR is not ok based on this image? You mention facets being shot - can you see something in the image that points to that? I don't know what bad facets look like - it would be great to be able to know what that looks like.

My disc heights appear to be normal or there was no mention to loss of disc height from my 2011 MRI. In 2009, my MRI showed a mild loss of disc height but then had the Fibrin Sealent Injections L5/s1, L4/5 and L3/4 which I think restored the disc height. Was hoping that it would be the easy fix but it was not.

U cant see facets from the side. But when the disc is that far gone (and that disc is complete fked, just nothing left), load transfer is increased through facets as well and they tend to follow similar degeneration.. therefore disc height is regained and facets mobilised, continued pain from mobilisation of arthritic facets joints that were previously stable.

If you google facet arthrosis, i found some ppt slides a while ago that showed it at three diff levels of degen. sorry just not in the mood for doing leg work, look through old posts go to member jstuckey blog, i wrote the link on there for one of her comments or look for size of gap between facets on coronal ct, on coronal mri look for thin black cartliage layer

or just get second opinions

To try to restate Hooch's point, you mention on another post that your back pain has been with you for a long time. That coupled, with the CT finding effectively no disk height, makes it very likely you have facet arthosis but you can't see it on the CT image you posted. If you took the images that are produced to slice through the spine on a plane parallel to the floor (while you're standing up), you should be able to see the facet condition.

Thanks again folks. The surgeon was concerned about facet arthritis but cleared me based on my CT scan. He ordered the CT just for that purpose alone. Can I trust him completely? Who knows? But I need to trust someone. Do you guys think ADR will fail for me because of this? I'm curious what you think may happen (totally understand it's your opinion but I really value it). Will I get no relief? Get relief to my current pain but cause new pain? Let me have it! Thanks again!