lumbo-sacral imaging post spinal fusion

[jakesaw]

I'm an MS-IV and have a history of a L5-S1 spinal fusion for spondylolisthesis many years ago.

Lately I've been having some worsening of LBP. X-ray was not informative and so my doc ordered a lumbar MRI. I had doubts this would be useful due to the fusion screws and metallic hardware in place, but my doc AND a neuro AND the MRI center said it could still be done.

Well, of course there was so much distortation at the level under question that the radiologist couldn't read anything.

Can anyone suggest what study would be appropriate for this? Thanks for any info.

Mike

---

Members don't see this ad.

 

[Docxter]

I'm an MS-IV and have a history of a L5-S1 spinal fusion for spondylolisthesis many years ago.

Lately I've been having some worsening of LBP. X-ray was not informative and so my doc ordered a lumbar MRI. I had doubts this would be useful due to the fusion screws and metallic hardware in place, but my doc AND a neuro AND the MRI center said it could still be done.

Well, of course there was so much distortation at the level under question that the radiologist couldn't read anything.

Can anyone suggest what study would be appropriate for this? Thanks for any info.

Mike

The area of abnormality may or may not be obscured by the hardware distortion artifacts. There are some tweaks you can do in choosing the MR sequences to decrease the image distortion, so if you go to a reputable center that knows how to make those minor tweaks, you'll have a better chance of seeing the area. just give it a try and they may see something.

 

[Whisker Barrel Cortex]

A CT myelogram may yield better results. This involves instilling contrast surrounding the nerve roots in the lumbar spine. There is often artifact with this as well, but can yield better results. Also, as MRI protocols can be adjusted to get decent images, even with hardware.

 

[jakesaw]

A CT myelogram may yield better results.

>>>May I ask how much better a CT myelogram might be? T

The initial MRI was of extremely poor quality. It was done on the weekend by a tech who was likely unexperienced in any sort of the tweaking you mention (and noone around to help him), so I'm debating if it's worthwile to insist they repeat the MRI (especially given the cost involved).

 

[jakesaw]

Thanks so much for the input. It is greatly appreciated.

 

[bugmenot]

how about a pet scan?

 

[Docxter]

how about a pet scan?

Huh?!!!!!? PET scan for what?

 

[Docxter]

A CT myelogram may yield better results.

>>>May I ask how much better a CT myelogram might be? T

The initial MRI was of extremely poor quality. It was done on the weekend by a tech who was likely unexperienced in any sort of the tweaking you mention (and noone around to help him), so I'm debating if it's worthwile to insist they repeat the MRI (especially given the cost involved).

You can show the parameters on the scan that you have done to someone who knows about this stuff, and they may tell you it's already optimized and another scan would not help that much. Then you know that a second one won't help and you could go for a CT myelo.