Spinal Cord Injury Rehabilitation Archive Questions

Below are Dr. Gorman’s answers to Spinal Cord Injury Rehabilitation questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 3 of 3.

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Q : 1 02/13/2009	I have had some type of painful lesions that have gathered around my spine and other boney areas of my body. Some doctors find them hard to palpate. They are very tender and do not go away, but spread. Dermatologists, Rheumatologists, Endocrinologist, etc. have all turned me away. I don't know who to go to for a biopsy of these lesions. When I touch them in my lower back, the pain radiates in a straight line up to my right shoulder. They have become worse in my lower back and straight up my spine. (I do have spinal problems and have problems having bowel movements which a general surgeon suggested could be neurological). I am not sure of who to see or who to ask these questions to. Can you help me? If what you say is true, then something like an MRI of the spine may help. This may end up showing nothing and you may not need a biopsy. We typically do not biopsy unless CT or/and MRI shows a lesion that can be biopsied. I would thus start with an imaging of some sort, which would be ordered by your primary care physician if he or she deems it necessary.
Q : 2 09/10/2008	In 2006, I had a L3 vertebrectomy. I was diagnosed with renal cell carcinoma with metastases to the lumbar region. Since that time, I have had level 5+ pain. The pain subsides when I lay down, but when I walk, sit, or stand, the pain increases. I have been hospitalized twice for pain management. The only solution suggested is what they call "micro movement" of the cage that was placed in the L3 vertebrae section. There must be some way to fix this post-surgical problem. I had radiation, and I am now taking sutant for the renal cell cancer. In July, metastases was reappearing in the spine area. It is difficult to comment on the situation without knowing the MRI appearance and radiation details. The pain can come from variety of problems, including pressure from the bone, tumor, scarring and others. There are options for effective pain control, including placement of pumps or stimulators in the spine. Therefore, it is worth while getting an opinion from a pain specialist. Regarding local tumor recurrence, this has to be thoroughly discussed with the medical/surgical/radiation oncologists, as this may be the cause of pain.
Q : 3 08/05/2008	My father is 75-yrs old and has a tumor on his spine detected by MRI and CT. At the same time, a 11 mm lesion on his lung was detected. The spine is causing him a great amount of pain but so far he is not suffering paralysis, incontinence, etc. The MRI and CT was conducted 2 wks ago, then a consult with ortho, then PET scan, this coming week a radiation consult, blood work, then a lung biopsy followed by a consult with oncologist on diagnosis and treatment plan. It appears it will be 4 weeks before any kind of treatment occurs on the spinal tumor from the time it was detected on the MRI and CT. Is this a normal length of time? The pain continues to worsen for my father. It is very difficult to judge whether this is a "normal" time period or not without knowing all the details. It is clear that physicians are monitoring your father's condition. We always try to move things along in an expeditious manner; however, it is not unusual that it takes 4 weeks to get therapy started if the situation is sufficiently complicated. A simple thing like uncertainty in the biopsy can delay things. It is imperative that you contact his physicians immediately and call 911 should his neurologic symptoms worsen abruptly, such as paralysis.

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