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Neurology (Expert Forum)
Problems reading CAT Scan
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Problems reading CAT Scan
by mjh007, Jun 15, 2005 12:00AM
I underwent spine fusion L5-S1 8 months ago. After 12 weeks of PT I have so much pain in my lower back and right thigh that it hardly seemed worth it. My doctor/surgeon had me get a CT scan and the radiologist that read the scans stated I now had a herniated disc at L3-L4 but was unable to determine any further damage due to the fact that "artifact was obstructed" due to the rods and pedicles from my fusion. So my doctor ordered anothe CT at the hospital I had the surgery at and that radiologist stated no nerve damage, nothing about a herniated disc, a bending screw with no fracture, and also stated an "obstructed view" of anything else.
My questions is this: Is it possible the pain I am experiencing is due to something not visible becasue of the rods and screws?
How often do 2 different radiologists find such different opinions?
Please help, I don't know what to do anymore.
Thanks in advance--
mjh007
My questions is this: Is it possible the pain I am experiencing is due to something not visible becasue of the rods and screws?
How often do 2 different radiologists find such different opinions?
Please help, I don't know what to do anymore.
Thanks in advance--
mjh007
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jun 16, 2005 12:00AM
Unfortunately metal produces significant artifact when a CT or MRI is performed in the area of it. The xray beams lose their focus and scatter when they hit the metal, disrupting the image around it - this makes it sometimes impossible to interpret
Radiologists may indeed differ in their opinion especially if the herniated disc is mild or just a bulge (in which case it would not be causing persistent pain, I do not know it this is inyour case).
An alternative imaging option that may tell if there are any herniated discs or nerve root narrowings is a plain xray myelogram - you could discuss this with your doctor. It involves the injection of dye into the spinal fluid space followed by plain xrays of the spine looking for any filling defects in teh space around the spinal cord.
Radiologists may indeed differ in their opinion especially if the herniated disc is mild or just a bulge (in which case it would not be causing persistent pain, I do not know it this is inyour case).
An alternative imaging option that may tell if there are any herniated discs or nerve root narrowings is a plain xray myelogram - you could discuss this with your doctor. It involves the injection of dye into the spinal fluid space followed by plain xrays of the spine looking for any filling defects in teh space around the spinal cord.
Sorry about the pain, I too have had failed back surgery, and had considered fusion at times. It is possible that 2 different radioligsts differ in their opinion, as do orthopedics who interpret the information. 3 orthopedics may view the same film, and have varying opinions as to what they see. Also I beleive that Xray, CT, and MRI have different ways of projecting images, with MRI being the most sensetive. I am not certain if this is an option for you. I am sorry I cannot offer you more advice, I just wanted to offer you some support, as I know backpain can be horrible. You are not alone.