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CT Discogram next...

LumpyLLumpy Posts: 103
edited 06/11/2012 - 8:42 AM in Neck Pain: Cervical
Well, after 2 ESI's with good results and 1 with not so good results, my symptoms are coming back quickly (neck pain C5-6 & C6-7 with all the accompanying arm pain). I went to the NS today to see what the options were. He is sending me back to my PM for a CT-Discogram. I have read about it. It doesn't sound too pleasant.

I am wondering how beneficial this test is as a diagnostic tool. I also wonder about the procedure and pain. I have read the articles, but I would like to hear from your experience.

Thanks all


  • Howdy Lumpy,

    I've not had one. My NS and Neurologist feel that they aren't safe or reliable consistently on test results. When I asked them about the safe part, I was told that they can in fact further weaken an already affected disk (hernia, bulge etc.). The pain too as they put it, is to replicate your "pain"... As my surgeon put it, a proper physical exam and certain movements do that too!

    I've done some reading on these, and I am convinced I will never accept one for myself. Good luck with it Lumpy. :-)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • As Brenda my surgeon didn't find them as reliable in the use of the cervical spine. When he asked about doing one on me he gave me the rely ability of them in the cervical spine and I agreed it wasn't for me. However he in places chooses to use the selective blocks as a better means in the cervical spine. He did say he uses the disco on most of his lumbar patients just not cervical. It isn't often we see them used in the cervical spine so i will be curious to hear your results.
  • The reason for this suggestion, as I understand it, is that I am running out of options. The conversation was something like this. He didn't see any real surgical options from the two (contridicting) MRI reports and from reviewing the images. Since I had some relief from the ESI, he suggested basically behaviour modification and have a nice day. I said I could not do by current job with this neck problem. I wanted to be healed enough to get back to my life. That is when he said he would send me to the PM for this test. It really looks like I am heading for a financially catostrophic career change :(

  • Howdy Lumpy,

    I'm sure you already thought of this, but maybe another doctor for another look at what is going on with you? I understand fully of loss or change of career/life due to neck problems. Doesn't make it any easier, that's for sure!

    Did they give reason why the MRI's didn't agree? I am guessing it wasn't such that this MRI was "okay" but this one is worse type of case? I have no curve in my neck, so a recumbent MRI doesn't show my problems well, were as a positional (stand up) showed everything bigger than stink. so....

    1. New Neurologist / Neurosurgeon
    2. Positional MRI
    3. Change of meds / PT?

    Please keep us posted on how it goes Lumpy. *HUG* Positive thoughts your way.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Thanks Brenda. The NS I have right now is the best of the best. I trust his opinion on the surgery, but I get the feeling if it isn't going to be surgical he doesn't want to spend his time on it. He is NS #2. The first one wanted to fuse me before I got out of the waiting room :)

    After our other thread (months ago) about the positonal MRI, I looked into it. My private insurance won't cover it and worker's comp won't either. I think it is an excellent idea, but not an option unless I shell out. The "contridictory" MRI's were more of an issue for me than for the PM or NS. Both of them looked at the film themselves. BOTH MRI's were practically identical. The radiologists' reports were worlds apart. One was very thorough. The other was almost dismissive and shallow. Go figure. The PM looked at them and just shook his head. He said it was amazing to him to see reports that were so drastically differant. Apparently it happens all the time. It did screw up my WC claim though. Those jokers don't look for themselves. They just cherry pick the facts to make the conclusion they want. X(

    PT has helped some in conjunction with the ESI. I think, though, I will end up giving up my work like you had to. Probably not complete disability, but partial. My work is way too physical at times.

    And for the record: I HATE pain meds.

    I know this post sounds negative, but I am actually in a pretty good state of mind about it right now (I took my pain meds :), it's a love-hate relationship ;)
  • Howdy Lumpy,

    First off, "post sounds negative"... Noppers! Not at all. I found it clear and informative, never-mind being very "matter of fact" as they say. :-)

    BCBS (Federal) doesn't make any stink whether the MRI is recumbent or positional. The only call I've ever gotten from my insurance was concerning my bone growth stimulator! They thought it was an implant or something, and too wondered why I wasn't doing regular follow up visits for this "implant." Once I explained it to them, they were fine.

    At our local hospital, we have a radiologist that is down right LAZY. I had an MRI there a few years ago, and he didn't mention the herniated disk at C5/6! Untrained ME could see that critter straight up! I got another radiologist to review it, and a whole different report came out! Have you taken your disk or films for another radiologist to read and report on? Although my NS reads the CD himself, he likes the reports to match fairly close to what he interprets. He said that he does that to reduce confusion with insurance, WC etc. Makes sense to me. "Joe *lazy* radiologist" says all is dandy, yet they fuse you? I can see the insurance company on that one! (G)

    Job change. Bummer man, sorry it is coming to that. My job both on the ground and in the air, very physical as well. Ever since my Ulnar was transposed and the Ulnar moved in my palm, I haven't flown a helicopter. When I was just getting released to fly fix wing (Citation jet), my C6/7 went, that was it for my flying career. When they found the nerve damage was permanent, that is when I basically had to file for and get disability retirement. Fortunately my mess started in stages, so I was adjusting as my nerves betrayed me. It doesn't sound like you are getting that sort of "re-adjustment" to your new life? Are you starting to put together "new career A,B,C" yet?

    *HUGZ* In support Lumpy! The fat lady hasn't sung yet! Oops, knew I forgot something, written reports not considered, did your NS look physically at the films or CDs of both MRI's to see what was really there? I ask that as I stated above, my NS looks over the actual views regardless of the reports. Please keep us posted. *HUG*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I find it interesting that there are no posts from people who have had this. Has anyone reading this thread been through this proceedure? What were the result?

    BTW, I see my PM this week. I'm anxious to hear his opinion/suggestions since he is the one who will do it, if I have it.
  • Hey Lumpy,

    I noticed that you are work comp and they took the cherry picking method which is typical and they will over write the NS also make no bones about they apply some tactics that you don't see. But you have another recourse on the MRi's without doing them over. You can A. Ask for a independent reading through a work comp doctor or B. You can pay for a independent doctor to read the films. But i would have both sets read. Also to keep apples to apples be sure they are radiologist. Basically I am telling you this to protect yourself in work comp.

    Sorry I can't be of more help in the disco area. But I have been to a disco back in the 80's, some how i think they are not the same. One may argue they both are painful though. LOL ...jk.
  • Thanks Tamtam (except for the part reminding me of 70's 80's discos. Some memories are better suppressed ;) )

    I am considering the independent radiologist route. I'm not sure what it would cost, but I think it would cost me more to let the WC have their way. Believe me, I know what that system can do. They do have to be careful about cherry picking. If they contradict themselves in order to deny treatment they could face a bad faith lawsuit. Very costly in our state. I don't give a hoot about their money. I just want to be at or close to the point I was the day before I got hurt.

    If I could pay for it or if I could get my insurance to pay for it, I would completely start from scratch with unbiased opinions. Though I must add, I trust both my NS and PM to give honest info. I just don't trust that the correct decisions will be made after that. Okay, I better stop or I'll tick myself off :)
  • I went to my PM today and had a long talk about my options. We are going to move forward with the Discogram with CT if I can get WC approval. The PM said the discogram makes sense at this point and he is thinking "annular tear". Ironically, someone resurrected a thread about this in the last couple of days. Looks like the discogram is a good test to clear up an otherwise cloudy dx. Also that thread rings a familiar note to me. Maybe, maybe, maybe some answers soon...
  • If you search the forum and use the word discogram, you will get a few threads that pop up about this. I believe they are mostly, if not all lumbar discograms and not cervical.

    During my discogram they did find all three of my annular tears, prior to this they only saw one with the MRI. I finally had a doctor tell me that there was a concrete reason I was in as much pain as I'm in, two of my discs are shot and caused severe pain during the test.

    The discogram was very painful and it took me a few weeks to fully recover form it (thy say five days to a weekish I believe and for many it takes a week or two). If you dont have disk pain however the pain shouldnt be bad at all and you should recover soon, there will only be significant pain at bad discs.

    Hope you the best and let us know.

  • Thanks for the feedback, Mitch. I think I'll change my user name to "Neednewneck" but around here, that would be anyone ;).

    I am not looking forward to the discogram so much as looking forward to getting answers. Maybe the idea of the pain should scare me, but it really doesn't. I just spent a night with an hour of sleep, so it has become a way of life.

    I'll do somemore homework on the proceedure and try to be ready.
  • Lumpy,

    You have the right idea. Yes you will have pain up front but then you know it is short lived and possible benefits at this time far out weight the short lived extra pain. Good luck and keep us posted.
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