Spinal Anatomy Lesson

Last Saturday at work, Dr. Scully happened to be the doctor on call and rounding on the surgical patients.  I was fortunate to have one of his partners’ patients, so I was able to talk to him.  The first thing he asked, “Did you get the MRI?”

When I told he I had, he finished his rounds and then took me over to a computer to look at my films.  He started with the thoracic region, which is the spine in the area of the chest/rib cage.  Nothing abnormal showed up on those scans, which made him pleased.  He then brought up the images of my lumbar region.  With a pen, he pointed out where the sacrum is –which I found a little annoying since I knew where the sacrum was!– and then counted up to the L3 (short for third lumbar vertebrae).

Now this is where I will teach you.  Below is a picture of a lumbar vertebra from two angles.  If you look at the axial/overhead view, you will see that vertebra look a little like a bumpy ring of sorts.  The bumpy parts have different names but whenever a patient has a laminectomy, they are working on those bumps.  The most prominent bumpy part is what people feel when they run their hands over a spine.  The bigger, denser part is known as the body.  It is the part that we can’t feel because it is inside our chest or abdomen depending on the section of spine we are talking about (our spine is divided into four parts: cervical in the neck; thoracic in the chest area; lumbar in the low back and sacrum or “tail bone”).  The gap between the bumps and the body is the spinal canal where our nerves and spinal fluid are housed.

Dr. Scully pointed to a glowing blob that appeared on the L3.  It was very prominent on the scan, even I noticed it, and Dr. Scully called it “worrisome.”  The tumor is on/in the body.  Dr. Scully cannot remove it with a posterior approach –or by simply opening my back and removing the offending piece of bone.  Instead, he would have to work with a general surgeon, open me with an anterior approach (cut open my stomach) and move all of my organs and my aorta out of his way.  Then he would have to cut out the body of my spine and replace it with metal.  The surgery would require more recovery time than a simple back surgery.

The question I had: would he do it?

In the words of my favorite spinal surgeon: “Oh hell yea.”

But first, he wanted me to find out if it would respond to radiation.  He felt that a less invasive approach, if it would work as well, would be better for me.

That’s where we left that decision.

On Tuesday, I’ll meet with Dr. Ong and see what he has to say about surgery and other treatment options.  It’s the first available appointment he has before next month!  Clearly, this man should have some better insights.  I hope so.  I’m growing tired of dead ends.  It’s harder and harder to deal with them.

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2 thoughts on “Spinal Anatomy Lesson

  1. Lisa says:

    Hi Janine — we haven’t met (my mom has cholangiocarcinoma, and we e-mailed), but I am thinking and hoping all the best for you. — Lisa

  2. exiledtyke says:

    Oh hell yeah! Sounds like just the man for the job! Good luck with it.

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