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Wednesday, June 19, 2013
Spine and Back Health
Small disk protrusions on MRI
I am currently undergoing testing for MS. Is it possible for an MRI thoracic spine w/wo contrast that has "two very small disk protrusions one at T7-8 and one at T-9-10 with no cord impingement but minimal indentation of the dural sac" to actually be MS lesions? No abnormal gandolium enhancement or sign of demyelinating lesions. My main sympmtoms are bladder and arm/hand tingling and right leg weakness. Is it easy to misread a disk protrusion that is actually a lesion? Thanks!
Hello, thank you for your question. No, the lesions one sees in MS are within the spinal cord itself, and would not be mistaken for a disc protrusion, which would be in front of the spinal cord. Very small disc bulges (or "protrusions") are very common in the thoracic spine in the general population, and are usually completely incidental and harmless. Based on the description you've provided, they should not have anything to do with your symptoms. Have you had an MRI of your cervical spine? If your symptoms include hand and arm problems, you need to have an MRI of your cervical spine (neck). Also, any workup for MS should include MRIs of the brain and entire spine, not just thoracic spine. Good luck.
David J Hart, MD
Associate Professor of Neurosurgery
School of Medicine
Case Western Reserve University