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Tests post-op to show bone growth

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:30 AM in Back Surgery and Neck Surgery
I've heard some people say they are given MRI's, some CT scans, and even CAT scans post-fusion to see if there is bone growth. I cannot have an MRI, but because of some of my issues, and for curiosity as to whether fusion is working, I want to know what my NS should order for me. I need answers regarding my night problems (see sig), and I really need them now. I have not been released for work, but since money is now non-existent, I need him to tell me go ahead or put it in my notes that my recovery is going to be longer than originally expected. I also would like some kind of estimate as to WHEN he thinks I will need the second fusion (for L4-L5), that he originally considered with a 2 level, but decided against.

Thanks :p



  • More than the fusing, I'm looking for the reason for the pain at night (fusing is a curiosity at this point, since so far they have done 3 xrays, and never said anything about fusing, just about everything being in place.)
    Will a CT show if something is wrong, or would it need to be a CT Myelogram?

    I have another question I will be asking my NS next week, I've developed total skin numbness just above my scars, this is also where there is a lump (that the NS's nurse/practitioner said is small, she's seen larger) The numbness is approx. 3 inches in height, spanning about 4-5 inches across my back. Anyone have this or know if it is normal?
  • the lump above the surgrey site. Was told this was swelling of tissues. Also the pain at night when you lay down. I got that too. I am fine all day, until I go to bed. Thats when the muscle spasms start. They come on so quick that you have no warning. The muscle relaxers don't work. This all started about 2 weeks ago when I started pt. My surgry was 1/29/09, spondylolisthesis, bolt thur my s1 into my l5. rods and screws, and bone fusion of s1 l5. Cat scan in March showed new bone growth. Next cat scan May 1st.
    I hope that you start to feel better. Stay positive.
  • Xrays are used to determine if the hardware is in place and has not moved. Xrays can not determine if you are fusing. A CT Scan is usually the gold standard in determining if you are fusing.

    Paul, Titanium cages would not preclude someone from having an MRI. Titanium is not magnetic.

  • Amanda: I still don't believe what I'm having is muscle spasms, it's not the same feeling (and I DID have a severe muscle spasm last night that lasted until my last Valium kicked in), I'm sorry you are feeling the same way. It's worse at night, because under normal conditions when you wake up to "wee" it's nothing to go back to sleep, but pain takes all your sleepiness away. I think that's why I do better taking Valium, because as painful as it is to get up, the pain doesn't knock the Valium out of my system.

    As for MRI's, I can't take them because of prosthesis in my ears from old surgeries, and we don't know what they were made of.

    Do they need the myelogram to show bone growth or further disc degeneration, or does a CT alone work?
  • I've had 2 CT's since my fusion. The 3D view is really cool. You can see where I fused on only one side at the L4/L5 level. This does not show up on an xray which is why they should not be trusted to determine if you are fusing.
  • Will ct alone also show the degeneration? or further nerve impingement?
  • CT might show these things but not as well as a Myelogram. You shouldn't have any further degeneration since you are fused, so I don't understand that question.
  • On a side note, the best method to determine if you are fused is via visual inspection. I for one am fused, verified visually and by a ct scan.
  • This is for L4, my fusion was L5-S1, my NS originally considered a 2 level, but opted for a single level. Last Xray, he noted further degeneration, so I NEED to know how soon he feels he will need to go back in for that issue. If it is as soon as I recover from this surgery, I have basis to get Disability. If not, I can start looking for more clients for my home based business. Once I start working again, I lose my insurance, so this information is VERY important. Sorry I forget not everybody reads all posts so my story is not known :p
  • Darn, I typed a long note and hit a wrong key! Hope I remember everything I had written.

    Like Dave said, CT shows bone while MRI shows tissue and nerve. The only way to positively say fusion is direct visualization(surgery.)

    I have some decreased sensation on my scars, which I expected since I have both have been opened up multiple times. I do not know the degree of your numbness. It does not bother me, just don't feel some direct touch unless it is hard. I am a firm believer in scar tissue massage. I chose a PT group that does a manual release technique instead of using metal instruments. It hurts, but it can break up superficial scar tissue and release the skin layers from the muscle. There is a noticeable difference when you look at my back. He also works directly on my scars. This cannot take care of deep scar tissue, but can with superficial.

    Sometimes a lump can form, usually soon after surgery, that is a fluid collection. If you are having back spasms and a lump, it could be a "trigger point." Basically that is just a really bad spasm-the body tries to protect itself by spasming and you get ball-like lumps. If that is your problem, therapeutic massage or trigger point injections can help. That is where usually a pain management doc injects numbing medicine and steroids into the lump, sometimes takes a couple of treatments.

    If you are having leg pain, a selective nerve root sleeve injection can be therapeutic and diagnostic-if it 100% takes away leg pain, then can be that the nerve is compressed.

    I have been told and have read that pseudoarthrosis(non-fusion) only causes pain by itself in a very low percentage of people. I am curious why your doc did not decide to go ahead and fuse the bad level above your fused level. Often if a level is bad above a below a fused level, the stress of a fusion will cause worse degeneration and will need surgery in 6 months to fix it.

    Unfortunately, it seems like time is not on your side because of insurance issues. If it were me, and this is my opinion only, I'd push for manual scar tissue massage by an experienced physical therapist(yeah it hurts.) This gives you another licensed professional documenting what is going on and the PT spends more hands on time with you than surgeons or NPs. I would also push for a pain doc who does injection-if you have leg pain for a selective nerve root sleeve injection or to see if the bump is actually a muscle spasm trigger point. I'd used a lot of ice packs on the bump and also ask for something like Zanaflex which will probably knock you out at night if you haven't taken it before. Again, just my opinion, but if you can bring new ideas in if they haven't brought these up, maybe it will help. And, another set of eyes(PT or pain injection doc) might pick up something else, it doesn't hurt to get another opinion or another discipline to work with your doc.

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