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    Old 04-15-2019, 09:10 AM   #1
    panko789
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    CT vs MRI

    Can anyone tell me if a CT shows more than and MRI? Just curious if someone is complaining of symptoms and the MRI shows nothing, would a CT show more in the way of nerves or are MRI's still the best method.
    Also I have been reading about weight bearing MRI's. I asked my surgeon and he sort of blew it off..
    I said if I am not experiencing any pain when I lay down, but experience it when I sit or stand wouldn't it make sense something is touching a nerve or bulging when I sit or stand so and MRI with weight in that position might relieve something? Anyone have any ideas?

     
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    Old 04-16-2019, 07:02 AM   #2
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    Re: CT vs MRI

    Dear panko,

    Sometimes all that is needed is an x-ray. Sometimes a scan reveals nothing.

    What happened? were you in an accident? what are the symptoms?
    Does movement cause the symptoms to worsen or are they there with no movement, or both?
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    Last edited by Administrator; 04-24-2019 at 11:56 AM.

     
    Old 04-16-2019, 07:11 AM   #3
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    Re: CT vs MRI

    I have had X-RAYS, both normal and bending forward and back. X-Rays showed nothing, I have had MRI's as well. I am asking if a CT will reveal more than and MRI as far as a nerve being pressed by something.

    I am pretty confident I have something pushing on a nerve, pain when I stand and sit (weight bearing) but no pain usually when I lay down. I had Discectomy a year and a half ago from an injury.

    Symptoms are leg tingling in both legs, numb feet, some sciatic type pain on left outside calf.

     
    Old 04-16-2019, 07:22 AM   #4
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    Re: CT vs MRI

    MRI test typically offers more detailed information than a CT scan.
    Is the pain in your back? Is it a sharp jolting pain or an ache feeling?

    Irritation from movement or sitting or standing would not necessarily be seen from a scan. It seems that a practitioner would do well to examine that body part manually and check your movement to find out when you get pain.
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    Old 04-16-2019, 07:26 AM   #5
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    Re: CT vs MRI

    You said typically? So in some cases can a CT Scan show more? I guess I am back to my original question. Not sure why you asked if I was in an accident and about symptoms? but thanks for your reply.

     
    Old 04-16-2019, 07:49 AM   #6
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    Re: CT vs MRI

    Dear panko,

    Why one test may show something another doesn't show depends entirely on what is wrong. Rather than to insist on specific tests, ask the doctor to find out what is causing the pain. You will be more likely to discover what is wrong and what is required to fix it. Why we have the pain does make a very big difference.

    Pain when standing and sitting and no pain when laying down usually means the body is out of shape, lacking good muscle tone. Weak back and stomach muscle is a common cause of joint and back pain, esp. when the pain is while standing and sitting.

    It is totally possible that exercise and muscle tone may completely resolve your pain. So, while a scan not showing anything is frustrating, it is also good news. It means that we can do something to help ourselves feel better. Ask your doctor if you would benefit from physical therapy.
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    Old 04-16-2019, 07:56 AM   #7
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    Re: CT vs MRI

    I appreciate the reply. I have tried different forms of PT and when I start to increase reps or exercises I always end up with my back going out again. I can hardly lift anything over 15 pounds and feel like something must be pushing on a nerve for my back to keep going out. I knew I had a ruptured disc pushing on a nerve before I even had the MRI, no one would operate so now I have nerve damage in that foot and lower leg from the nerve being pressed for 5 years. Had they done surgery I believe I would be fine now.. but here we go again 50 years old living like I am 70. I told the doctors last week if you say I am ok I am going to go do things I was doing before and see what happens. I hope I do not re-injure the nerve but have a good feeling I will be back in their office for another surgery. I believe my issue is a nerve being pressed at L5/S1. When they did my L4/L5 surgery they said the L5/S1 looked bad too. My question is if it was bad then why would it not be bad now? Thanks again for you help and I will update if something happens either way.

     
    Old 04-16-2019, 08:25 AM   #8
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    Re: CT vs MRI

    Dear panko,

    I sure can appreciate that you would like to get back to 100%.
    Don't get frustrated, now. We can't learn your whole experience in a few posts.
    My story is a long one. Suffice it to say I have to limit what I try to push or pick up. Just sitting upright is a trial. It would be great if laying down was pain free, but for me it isn't.

    Possibly down the road you will require another surgery. But simply having some pain isn't a good reason to have another surgery. We also need to accept limits because the body does not keep on recovering so easily. Due to your injuries, further surgery may not ever be responsible or even possible. Multiple surgeries to try to get back to square one usually weakens the body further. Surgery needs be the last resort. If you really want answers consider getting other opinion outside your medical group. Be careful though, because doctors are just human and can be looking at dollar signs more than your best welfare. That has happened to me more than once!

    As I age (closing in on 70 but this started from a serious accident at age 17) my limits are quickly shrinking. Ok, no more going out and mowing the back 40, you know? There are a LOT of things I can no longer do, and have not been able to do these last 40 years. I was a very active lover of hard physical work, but those activities are no longer for me.

    You can always get second opinions outside of your medical group. But, always expect a medical group of doctors to support each other. That is just what they do. Not against us, but they trust each other for a reason.

    OK, so get an outside opinion.
    Is it possible that your injury now requires a back brace?
    I have found that a back brace helps me a great deal.
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    Last edited by Administrator; 04-24-2019 at 11:55 AM.

     
    Old 04-16-2019, 08:54 AM   #9
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    Re: CT vs MRI

    I know I am not a professional Golfer I guess other people have the money to get well, when some of us are left to deal with pain or mask the pain or even suffer. I have done sports all my life and physical activity. I am too young (50) to be acting 20 years older than I am. (no offense) but I can't imagine not being active or able to do simple things like painting around the house yard work etc....

    Last edited by Administrator; 04-24-2019 at 07:35 AM.

     
    Old 04-16-2019, 09:14 AM   #10
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    Re: CT vs MRI

    Panko,

    I hear you! I have continued to do as much as possible since my crippling accident and underwent surgeries etc to get there as much as seemed feasible.
    I still cannot imagine not doing the things I used to do. I imagine them every day, in fact I dream of those things. I just know I physically cannot do them, in my case. There is a limit, too, on what I am willing to accept that very well might end up much worse than where I am at. Surgeries, as I have experienced, do not always turn out the way we plan.

    If you want other opinion on what is safe or beneficial for you, all you have to do is go outside of that medical group that is so far fine with your present progress. It also requires your insurance to be willing to pay, so there is that hurdle to get over.

    But fresh eyes on the subject would probably help you. By all means do get opinion outside your medical group and see what you find out. In America, I think insurance has to pay for one opinion outside your present medical group. Call your insurance company and explain what you wnat and ask if that is covered.

    And, do a lot of research before you choose which new doctor to see.
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    Old 04-16-2019, 04:42 PM   #11
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    Re: CT vs MRI

    Are you seeing orthos or neuros? You should be able to find excellent neuros in your area...maybe at a teaching hospital or a sports med group

     
    Old 04-18-2019, 05:53 PM   #12
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    Re: CT vs MRI

    Just seeing your original question and skimmed through responses. I hope I can provide a similar experience that might be of help...but first I would like to ask if you had the MRI report and if it truly reveals “nothing?” You mentioned having had a discectomy...when was that and which level?

    My first surgery was a fusion at L4-5 because I had a spondylolisthesis...my symptoms were sciatic pain which eventually made it difficult for me to stand or walk. For the most part, it was relieved by getting out from under the weight of gravity...ie., lying down, sometimes sitting. My surgery was medically “successful” but it did not provide relief from the sciatic pain. Thus began my “journey” to try to resolve my symptoms. My surgeon was willing to work with me but the MRI looked “fine” and showed the nerve was no longer compressed. He suggested pain management, who, of course, suggested “trying” a neuro stimulator.

    I said no thank you and vowed to myself to keep looking for answers because logically what specialists were telling me didn’t add up. If I had nerve damage, I felt I would have sciatic pain all the time...it wouldn’t be situational.

    There were no facilities in my area that did positional MRIs so I had one when visiting my daughter who lived in a different state. The interesting experience I had with that was when I went to a fairly well known spine surgeon in Chicago and presented all my records, he refused to look at the positional MRI, and only went by the traditional prone MRI! I was hoping the positional MRI would provide the missing information...but, alas, it did not.

    It would take too long to go into the rest of my story...and how I was able to find the correct path...but suffice it to say that it took me two years and probably seeing six more spine surgeons before I found (convinced) someone who helped me. I ended up having a three level fusion which resolved my issues. I had an issue that did not show up on any imaging and was a big surprise to my surgeon when he cut me open for the 3-level fusion. Luckily it was the day after Memorial Day weekend and most of his other surgery patients had cancelled, so he had some extra time that surgical day...he ended up having to do some reconstruction at L3-4 as the facet joints had worn away to nothing! I was pretty much unstable at L3 even though my symptoms all indicated a problem at L5.

    Ct generally shows less detail than MRI but neither show much about nerve compression other than what is quite obvious.

    I’ll go back and read through your post more carefully to see if I find any details that reveal more about your condition....what type of specialist did your discectomy? Did it provide relief from the sciatic pain? If so how long did it last before the symptoms returned?

     
    Old 04-19-2019, 03:45 AM   #13
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    Re: CT vs MRI

    An MRI will show more than a CT when it comes to nerves.. a MRI with contrast will show more than an MRI without. Does this help?
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    Old 04-22-2019, 07:12 AM   #14
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    Re: CT vs MRI

    That is great to hear and sounds like sort of what I am going through. I had to L4/L5 discectomy. It did relieve all or 99% of my sciatic symptoms, but the neuro surgeon said my L5/S1 did not look good but he didn't want to do both. I have been back to them had another MRI because I know something is pressing on a nerve somewhere and all MRI's show nothing. I keep saying well did L5/S1 cure itself? If it was bad before why is it fine now? Could that be causing issues now? I even went to another Ortho the other day and he looked at MRI's and said I don't see anything. So I said I can go back to doing what I was pre surgery. He said well I am not saying something isn't pushing on a nerve somewhere but I don't see it. I went and walk ran a mile 3 days later... back was hurting as I knew it would, but very little sciatic calf pain. I started doing the Stuart Mcgill 3 core exercises and even Bird Dog hurts and side plank hurts. If I try and increase reps or time, I will end up throwing my back out the next day just reaching for something. My surgeon said next step would be a fusion but you are too young. I am 50... I said well I rather be able to do normal stuff for 10 more years than feel like a 70 year old now... Don't get me wrong I am glad they don't want to just cut me but man I wish someone could tell me what is going on? Did the surgeon you used explain or could they tell you why nothing showed on the MRI but when they opened you up they could see it? I always thought facet joints were bone and would show on an XRAY? Thanks for any advice.

     
    Old 04-24-2019, 12:49 PM   #15
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    Re: CT vs MRI

    Being a veteran of 4 lumbar surgeries, I would recommend trying lots of other things before entering into a fusion IF you do not have instability. I don’t see any other reason for doing it, because the results are too unpredictable.

    Yes, facet joint is normally visualized on MRI. My surgeon was shocked when he opened me up...so I don’t know if artifact from the L4-5 fusion kept them from seeing the deterioration...or???

    Also, a guy I go to for bodywork who is an acupuncturist and is trained in Chinese medicine but who has no western medical credentials but has tons of experience working with high endurance athletes, took my MRI and took the time to go through it slide by slice by slice. Using the computer and working at L5-S1, he drew angles on a couple images that showed how the L5 nerve got pinched off when I was standing/sitting (due to the forces of gravity and the curve of my spine at this level). So even though the MRI showed “nothing,” analyzing my spinal body mechanics made a good case for a situational nerve compression.

    It was enough to convince my surgeon that there was a reason for surgery. My surgeon was impressed and it made sense to him...so when he operated, he assumed he was mostly dealing with a L5-S1 issue...even though another specialist, a physiatrist who did my epidural steroid injections, etc. kept insisting I was unstable at L3-4. He turned out to be correct. I was VERY unstable at that segment!

    Obviously people much younger than 50 have fusions. But there is nothing to guarantee a fusion would resolve the pain...and you could come out worse...have you ever heard of prolotherapy?

    Last edited by Administrator; 04-24-2019 at 01:10 PM.

     
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