Best imaging?

[painfree23]

What do you prefer for pts with previous (10 year old) lumbar hardware (let's say 3 level fusion) now with worsening radicular pain over the past few months ?

CT myelo?
Regular CT?

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[Taus]

Still MRI. Eval adjacent levels most clearly. Save the Ct w or wo myelogram for surgeon if revision being consider and mri not adequate


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[painfree23]

Still MRI. Eval adjacent levels most clearly. Save the Ct w or wo myelogram for surgeon if revision being consider and mri not adequate


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What about the artifact? Or it doesn't really matter bc ur not gonna intervene at the levels that have hardware anyway?

 

[Dr. Ice]

Surgeon will most likely order both ct scan fine cuts with reproduction and MRI. They can probably get both scans authorized if they describe reasoning. I have also been able to get both of these. Depending on how old the fusion is, you want to look for nonunion. Some surgeons will say MRI is not useful within 3-4 months post fusion but depending on the scenario I would at least do the MRI and maybe the ct scan also.