10-24-2008
10-24-2008, 02:28 PM
tconner94
MRI vs. CT
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I will try to offer a little info on your questions about imaging studies after ADR. MRI artifact at the level of surgery will prevent that level from being evaluated. If IV MRI contrast is given, it won't help visualization of the surgical level. MRI with contrast can be used to assess for nerve root irritation/inflammation away from the hardware, and it can be used to check for complications of the surgery such as infection. Also, the other levels can be assessed with MRI either without or with IV contrast.
I used the term "IV contrast" deliberately. CT of the lumbar spine is usually done without IV contrast. The ADR will cause a different type of artifact on the CT that will also affect the evaluation, but it is easier to compensate for this when viewing the CT. However, CT is not that good at evaluating disks, nerve roots, etc. I believe that you are referring to CT myelography. That procedure involves a lumbar puncture (spinal tap) where 10-20 cc's of contrast are injected directly into the spinal canal. A few regular X-rays are usually taken, and then a CT is done soon after to evaluate nerve roots, spinal narrowing, etc.
In general, it is difficult to predict in advance which test may help. MRI with IV contrast is quicker and safer, but it may or may not help. CT myelography may help, but it's more involved, a little riskier, and there's still a chance it won't show the ADR level due to artifacts from the metal.
Hope this helps.
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L5-S1 rupture 11/04, left leg pain for 2 wks.
Regular exercise/pain-free until 2007
L5-S1 degen. disease w/constant pain since 6/07
PT, ESI, SI jt injections, 3-level nerve root inj. x 2
L5-S1 Charite Jan. 19th, no back pain so far
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