Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: AWAITING CAT/MYELOGRAM RESULTS
Forum: The Neurology and Neurosurgery Forum
Topic Area: Spine
Posted by CCF Neurology MD - AY on September 15, 1998 at 22:08:33:
In Reply to: AWAITING CAT/MYELOGRAM RESULTS posted by SPONDY on September 15, 1998 at 19:05:24:


I have posted two prior messages regarding a "spondy" problem, the most
recent was 9/10/98. I have since seen a Neurosurgeon who seemed to disagree
with the first Ortho Surgeon's opinion regarding my condition. Neurosurgeon
doesn't seem to see the degree of "slip" that he feels would warrant the
degree/duration of my right foot/ankle numbness and weakness; although, he
does seem to agree with nerve root compression problem. He felt that the
prior MRIs were inconclusive and ordered a CAT/Myelogram test, which I had
done yesterday, 9/14/98. I expect to hear results on Friday, 9/18.
My questions at this time are:
1..Can you describe what is looked for in the spinal fluid/blood test comparison
studies? They are also doing a blood sugar test. Is this done ordinarily?
=
In your specific situation a comparison of metabolites/electrolytes between
CSF and blood is not all that informative, as it would in, say, Multiple
Sclerosis. Your neurosurgeon is also probably checking for Diabetes Mellitus,
or maybe it is just a routine pre-op test.


2. What does the CAT/Myleogram study show that MRI would miss?

=
The image interpretation of CT-Myelogram is somewhat different from MRI, since
a liquid contrast medium is directly injected into the canal space. It is
therefore possible to see the exact contours of the dural space, including
all the recesses and also evaluate space occuppying masses, such as discs.


3. Are there other medical conditions to be explored that would be
masked by the lower back pain?

=
Pain and sensory alterations are the most common symptoms in back problem,
however, once imaging and electrophysiologic studies are added to the evaluation,
very few pathologies would go "undiagnozed".

4. What questions should be asked to determine the qualifications of the
doctor to perform surgery? How do you know you are in the right hospital
setting for the appropriate surgery?

=
You probably want a surgeon and a surgical team has performed this procedure
regularly in the recent past few months. Most major academic/medical centers
would easily meet this criteria. In the final analysis, it does come down
to your level of comfort/confidence in your neurosurgeon/orthopod.

thank you for your repsonse, once again!

=
Thanks for your feedback.



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