Kickas.org Forums Treatments, Drugs and Alternatives Surgery CT scans vs. MRI

Hi everyone,
Only a quick question this time.
I can't fit into an MRI machine because of the way my neck is fused, so the only other option would be a CT scan of my cervical spine and head. So my question is, would they still be able to find everything they need to see in the CT scan? (in comparison to the MRI) They are looking for spinal cord complications.

Thanks for the help, It's always appreciated.
James.

Hi,
I got the CT scan done, but it took 3 nurses had to help get me positioned properly head first, but we got it done using pillows wedges and boards. The MRI would have been impossible for me to get into. If they find any complications with the nerves or spinal cord in my neck, I have a chance to get my neck fixed. I won't find out what the dx is until Feb 2nd, but from the earlier tests and cat, I found out that I have a new kidney stone, and nerve damage from the elbow down in both arms.
Take Care.
James.

Hi James,

I hope the CT scan is helpful to you - results should be in today. Keep us posted. Take care, Wanda

Hi Wanda,
Yeah the CT scans were helpful to an extent. I found out that I have narrowing of the facets and cervical spine, but I'm sure that is common among advanced AS'ers. I'm not sure if they were able to see everything though, because even though I got in the CT scan machine, my head still wasn't laying down flat. 'Paul in MD' mentioned that an open MRI is good, so I am hunting down a facility that has one, so I can comfortably have an MRI taken. Meanwhile I am doing what I can to keep the inflammation away, so that the problem doesn't continue to get worse. The way how things are looking, and with the luck I have been having, I might not be able to have any surgery.
Thanks for checking up on how my scans went,
Take care,
James.

A little late, but.....

I first had a bone scan, then a CT scan after I fell in Feb 2005. I persisted as my pain wasn't going away, and finally had an MRI 2 weeks ago. Short story is, the MRI found fractures in my T11 & T12 facet joints/vertabrae, more than a full year after I fell, of which the CT scan couldn't pick up. The docter pushed for the MRI because the bone scan showed very hot spot in my T11-12 area. Trouble was it took so long to get MRI because I was on Comp for the fall and their Ortho surgeon said an MRI would not add to my case, thus a fight ensued.

As to fitting into the MRI, just barely, my nosed scraped the top of the tube and my elbow was jammed into my side causing my hand to fall asleep, and I was in there for 40 minutes straight! I am 6 foot and 250 lbs, the max apparently that'll fit. Because I was propped up was why I touched the top with my nose.


I was a tube o' sardine.....

Gday James

I have a issue with L2/L3 since losing some weight (around 18kg/40lb). Ive noticed during stretches expecially when lying down, a sharp poking/prodding internally like bone pressing into muscle/tissue. Can be painful if i go to far.

SO last week i had this thing called a Scintigraph. Which is combination bone scan, blood flow, spectograph & CT scan. Included an injection of Technetium, a radioactive agent for blood flow, and a full 360deg image of my torso was created.

I pick the films & reports up today in fact. Ill let you know how that comes out & maybe its something you could suggest. Was a little uncomfortable as they want your hands above your head so not sure how youll go with your neck again.

Anyway food for thought.
Patrick

Hi
Sorry I didn't get back to this post sooner, I forgot to mark it as a favorite. I haven't heard of a Scintigraph or Spectograph, but its sounds like an alternative to an MRI. So how did they turn out? I believe they had you put your hands above your head so they can get a clear shot at your lumbar area. If this test is done for the neck it might not be necessary. Then again I wouldn't really know anyways, because I haven't had this combination of tests done before. But I will ask my new rheumy about this if he decides I could use another MRI, that's if he doesn't have an open MRI.

Thanks for the reply,
James,

Ahh Thanks Doug,
I knew there had to be a significant difference between the MRI and CT scan results. One doctor told me an MRI is nothing more than a color photo, but when I got to see my MRI of my heart, it was in color and in 3d while it was displayed on the computer. When I had that MRI done it was tough too, because my chin was rubbing and my elbows had to stay outside the machine, but it's really difficult to raise my arms. The cat scan I just had, they put me in head first so I didn't have too much trouble after I got in there far enough.

Anyways, what you said about your results from the CT scan and the recent MRI scan shows that there are some things that can get missed in a CT scan. so thanks for that, My neuro felt there was no need for further testing after mt CT scan. I feel like there is some damage up there, not just a narrowing problem, and my new rheumy must have seen something in my xrays, because he said he has no objections with me getting surgery. With all of the tests I was taking during my appointment, I didn't have too much time to ask alot of questions, but I am going to make it a point to have him go over my xrays with him on my next appointment.

Thanks,
James.

Hey James,
I don't know about where you are, but I know there are "open MRI's". I don't know how popular these are, but I'm wondering if that's something you could look into in order for you to get and MRI. When I first got mine they gave me that as an option in case I was claustraphobic...I turned it down so I don't have many details for you. But I do know it exists if you wanted to research further maybe this could help you?

Good luck,
Jess

Hi Jess,
Thanks for the advice. Actually it's a good reminder because someone else recently mentioned this to me. Open MRI's are hard to find in my area, but I just saw my new rheumatologist and he is located in a big new looking medical building, which not in my area. They had me going all over the place in that building getting tests and xrays done, so I was trying to peek around looking for an open MRI, but I didn't see one. I was going to ask them before I left the building, but they started to have a lot of other patients come in, and there was a line forming at the information counter. So I'm going to ask them about it when I go back this month. There is a good chance they do, judging by the size of the place, plus it's next door to the hospital, which is ten times bigger than the one in my neighborhood too. :-)

Thanks for the advice, I'll keep looking :-)
James.

hi, i had exrays 7 years into my a.s. and they found my bones had fused and the bones affected were extra white so they should pick up anything different. drewscot.

Hey James,

I know it has been a while since your post so I don't know if you have had much success yet but there is suppose to be an open mri in Akron per the links below. There is also one in Dover at SurgiCare. Believe it or not I was watching Discovery Health Channel last week and they were showing people who could not fit in mri machines at the hospital so they found an animal mri for larger animals at the local zoo and sent the patient there. Who would have thought of that being an option, I was amazed. The guy had the mri and the problem in his lumbar was found to be rickets and after a couple of well placed injections he was out of pain.

http://www.openmri-oh.com/
http://www.openmri-oh.com/locations.htm

http://goliath.ecnext.com/coms2/gi_0199-3103370/SurgiCare-to-open-MRI-center.html

I had CT scans back in the mid eighties and the surgeon found a ruptured disc in my lumbar, but sent me back to work stating a normal scan. After a few days at work I was unable to walk so I found my own surgeon who ordered the report from the first one and gave me a copy for my own records. He said it might have been possible given time it would have healed if the other surgeon would have put me on bedrest. But after sending me for an mri he found three ruptured disc which he ended up doing surgery on two of them because one had broken into pieces and the other was starting to fall apart also. Hope they find your problem.

Brent

Hi Doug,
Better late than never right? I came back to tell everyone that I finally got to have a MRI of my spine. They had to do it in 3 separate scans... I think because of the way I'm fused, but not that sure about that. It took 2 nurses this time, one of them was a very strong woman who was able to pick me up!!! Anyways, they had to use pillows and wedges from two different rooms to fit me in there. The had my knees so far up that I was putting all my weight on the back of my neck, and that started to hurt after a while. My nose was at a safe distance away, but my forehead was nearly rubbing. 2 hours later, when we were nearly done, my knees stopped me from going in any further because of how high they were. I sounded like and was as loud as a jack hammer in there that they had me wear earplugs because of the noise. I don't know what was seen in the MRI, but I already know I have an unhealed fracture. I'm still waiting to speak to the doc about this MRI. The thing that I don't understand is that I had an MRI of my heart before and the MRI they used then didn't make any noise at all. I think the only reason I got the MRI is because I got it ordered through a ortho-surgeon. My rheumy wasn't about to send me somewhere far away for an open MRI... for some reason... apparently.

Thanks for the reply.
Take care,
James.

Hi Drewscot,
That sounds alot like my exrays. The last bones to turn white on me are the bones in my wrists, no fusing there though.
Thanks,
James.

Thanks for those links peacepiper.
They helped explain why my new doc, (not the rheumy who originally wanted the mri), wanted to have an MRI and a CT scan with dye. I have my own copy of the CT scan but I haven't seen the MRI. He also got me an ultrasound and a nuclear bone scan the following week. It seems like alot in two weeks, but we're discussing surgery.
Take care,
James.

H Brent,
Thanks for your reply and sharing your story. What happened was after my rheumy found out that I couldn't get into the MRI, he stopped trying and kept changing the subject whenever I asked about it. Well, later on I figured since he wouldn't pursue examining my back fracture, I would talk to him about my neck causing me to choke and not being able to swallow correctly. He thought that was more important than me being stuck in a wheel chair for a fractured back, so he sent me to an ENT doc. The ENT made the decision that my spine needed fixing in my neck so he sent he to a top orthopedic surgeon who just happens to specialize in fractures. After me and the surgeon got to talking, he said he has no problem with doing either surgery but only one at a time. After we talked things over for a while, he decided that my first goal is to help raise my head to help enlarge my throat. (right now the diameter is only 50% of what it's supposed to be.) Anyways, he suggested that fixing my neck may take alot of stress off of my back and give my back a chance to heal, being that my neck is to far forward and hung low. My neck also had a compression fracture initially but I found out recently that it's not detectable anymore (must have fused back up or something), but I will still need the operation anyways.

Anyways, here's a picture of what I want to get fixed. This is side view image 21 of my latest CT scan on 01-18-08. It shows both the fractures and the narrow spinal canal.

I wonder if the MRI found anything I don't know about.... the waiting is hard to do.

Take care,
James.

Oops, I need to make a correction in my last reply.
It was a short referral from my rheumy to a neurologist who ordered the MRI, then later the CT scan...

My recent (successful) set of scans was ordered by an orthopedic surgeon...which has been a year later from the original post.

Thanks,
James.

James,

I think in your condition a CT scan would have been the right choice given the larger area you needed to be able to fit into the way your spine was. I do know they have some larger MRI machines spread out in different areas and also use them for large animals at some vet clinics.

From what I have seen and read about all of your surgeries and the brace I feel both you and the doctors did the best thing they could have and you have gotten great benefits from going through with it.

Right now for me I have fought hard over the last three and a half years to gain back as much mobility as possible to stay out of the wheelchair I walk by several times a day. To be honest that wheel chair is and has been my worst fear in life for many years. I was told in the early 1990's I should start thinking about the possibilty of myself ending up in one. With my now ex I knew if I could not do for myself I would get kicked out of my home. Then in late 2003 wen they found the spinal cord compression and told me I needed surgery quick or would be paralyzed from the nipples down my fears became even more real. Then a few months later they delivered the electric wheelchair.

Half of my doctor wonder how I walk or control my left leg at all, especially after spending two years going to surgeon after surgeon looking for someone to repair what damage they could. After they found two more disc in the neck causing cord compression the turn down rate for any surgery was quicker. All of the surgeons have said they will perform emergency surgery once the disc close my spinal cord completely. They talked about the rods, plates and screws several times until they saw how much the AS was affecting the bones and then I would get the story about my bones being to brittle to hold the screws and plates without them breaking loose and causing even more damage.

I can't tell you how happy I have been since I heard what a success your surgery has been and it gives me hope when the day comes that I end up having the emergency surgery. I now have a story I can tell my doctors that they can believe in.

Brent

Hi Brent,
I'm glad you found my posts about my recent surgery helpful. Like you, I tried hard to stay out of the wheelchair all along, and my biggest fear was that my AS would progress further along because of the lack of mobility, or that I might not ever be able to get back out of it. I've been using a manual wheelchair since the day I re-aggravated the original compression fracture. That happened about 3 months after I found out I had one. I was never happy about returning to the wheelchair, but I was able to find enjoyment out of being able to do things again. For me, it also doubles as my computer chair too.

Now that I had the surgery, I feel that I will be able to become a non-wheelchair user again, as soon as my legs get stronger, and my overall stamina/endurance gets better. My stamina is still low because of my restricted lung capacity so I really need to work on that. The soreness and pain from having the surgery does slow me down, but it has been going away a little each day.

Before the injury, I was fused in every joint in my spine. When I got the compression fracture, I also broke lose the fractured L1 vertebra. All of the weight from the upper spine was given to the bad joint, because the rest of the spine was fused and had no cushioning from the disks. I was also under diagnosed for Osteoporosis so my bones were also frail. That's why my L1 compression fracture never healed. I keep taking supplements for the Osteoporosis, with higher doses of magnesium, but I am back to being short on magnesium again. There must be something about my AS or my Ulcerative Colitis that's causing me to lose my nutrients. I think I am going to try drinking Aloe Vera Juice to see if that will heal any absorption problems I have. I already bought it, but I am using it to clear up my psoriasis at the moment.

The L1 fracture I had was very painful because it gave me my only movable joint that had to support the weight of my upper body. On the day that I re-injured it, my back folded too far forward and caused a temporary paralysis from the waist down, for approximately 20 minutes. Since then I had some mild to moderate neurological pains in my legs. The fracture hurted me every few minutes whenever any movement took place. AS it hurted, it would numb my legs and make them hard to use. whenever I stood up the pain would be constant and that make it difficult to use my legs.. except for only the first few steps. My narrowing spinal canal made it more possible for the neurological problems. I always had more neurological problems with my left leg. Right now I am not experiencing any of those problems because the injured part of my back has been immobilized and repaired. My left thigh is left with a slight numbness though, but it is much better than what it was just over two weeks ago. I'm thinking that the reason my surgeon decided to put bolts in 6 joints, was to make sure that the hardware stayed in place. He also did it because he wanted to correct my posture, but sometime during the surgery he decided to do that later.

I haven't mentioned this yet, but in therapy I am walking up steps now (stair stepping). This is something I couldn't do before. I used to dread going up and down curbs. All of my therapists are saying I am doing a great job at doing my exercises and they also say I am doing better than most of their other 'fusion' patients do. I think that may be because I have experience with being fused and in pain, and the other non AS people don't. Whatever the reason though, I am happy at the progress I've made, and even happier not having to deal with that pain and difficulty with my back fracture anymore. Despite the rubbing, the brace has been a huge help. It keeps all of the stress off of the repaired area in my back.

If you do get the emergency surgery I hope it goes well. I'm sorry that you have to wait until it becomes an emergency though. I think you're doing a great job with walking several times a day, trying to stay out of the wheelchair.

PS. My neck problems are due from my upper thoracic spine. This will be fixed later when the surgeon will put one or two wedges in my upper back. This will raise my head considerably and open up my throat, so that it will eliminate my swallowing trouble.

Take care,
James.

James,

I can relate well to the L1 fracture after lliving with severe pain from S1 to L3 for many years before my first back surgery. Many times I still have to roll off the bed into the floor and crawl to the bathroom in the middle of the night. During my first surgery to remove the crushed disc and repair the others the doctor noted in the durgery report I had an extremely small spinal canal. He removed pieces of the vertebra to make room for the nerves to go through, then a little over a year later when I had the second surgery he removed one of the fins from the back of the vertebra because the canal had closed back up. I have always felt the removal of the fin and pieces of bone the doctor took out is what slowed my fusion progression down.

From what you are saying I can tell things are going to get better for you as you build your stamina and strenght back up. Stairs and curbs slow me down a bit at the moment also, but for you to be able to start tackling them again you seem to be making good progress. I can imagine how hard the PT has been so far but the rewards we make it well worth the effort.

Hopefully after the do the upper thoracic surgery you will feel like a new man.

Brent