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new MRI w/out contrast show disc tear?

john 40jjohn 40 Posts: 190
edited 06/11/2012 - 8:50 AM in Back Surgery and Neck Surgery
hi going in for a new mri this week doc ordered without contrast , to see if i blew out what was left of my l4-5 or l5-s1 disc as i bent over and oops ,20 min later when i could get off the ground , things have not felt the same . my last mri with and without showed a large disc tear ,and looking back at the images i think the 3 that show the tear are with out the contrast ? i may be wrong .i though that was what the contrast was going to show? along with scar tissue.
my doc did not want to use contrast this time sense i have had some bad reactions to some meds lately SJS.
what i wanted to know was if the disc tear would show with no contrast?


  • Hey, my understanding is that they like to do with and without contrast b/c of scar tissue. I'm not a doctor but I thought the ones with contrast help further differentiate scar from disc material. I suspect that if you had a reaction, he's looking out for your safety.

    Did you have a reaction last time to the meds? If so, I can see his concern. Did you ask him what he'll do if the MRI without contrast doesn't show much?
  • I did not word my question quite right to the surgeon about what ifs ,he kinda funny some times hard to read,if u no what i mean ,most of the time he gos way into depth about what he is thinking,i think he is just wanting to see if things are worse than the last mri maybe the disc with the tear smashed out?he did ask me if i was ready for surgery yet .but he has asked me the same thing the last three appointments kinda kidding though. hes number 3 surgeon i have seen his rep is try every thing before jumping on the knife the first to wanted to do double fusion the first time i saw them.
    no i did ok with the contrast the last time just he had seen me when i had a reaction to the 'true test' allergy test patch not what was under the patches they wore testing for. just every wear else, i had a reaction to the patch its self,and i had shown him photos of my skin coming off from the reaction to the lidoderme patches.
    I just had been thinking that the tear would not show with out the contrast. but the more i look at the old mri i think it shows more on the ones without,
  • Helps with people who have had past surgeries in that area. Very good for pin-pointing tumors. Helps highlight the soft tissue better. It's also handy if you already have hardware. Since hardware tends to cause halos on scans. Especially on CT scans.

    Doing it just because is probably not in your best interest. If the surgeon doesn't want it he must be comfortable that he can get the info he needs. If you "blew out" the disc where the micro was already done. You won't need contrast to see it.

    The contrast usually requires 2 rounds on the table. 1st round without, then add dye to you, then 2nd round. If you're not comfortable laying on the table for an hour better take something or ask for something. They want you completely still the whole time. It's not fun trying to stay dead still that long.
  • I found my last mri report.it say right in the first part pre contrast t2 shows sings of large tear'
    wow i must be really out to lunch ,to many meds or not enough,
    thanks zo6 i think he just wants to see if L4-5 is worse as it had a large bulge last time ,i think he know's the l5-s1 is done with ,as the worsening leg an foot pain. just now it is moving into the right side and top of my foot too, big toe,
    he had me set up for injections, i just had to get allergy tests done first, witch found i should be ok with the lidocaine and what ever the steroid was.
    but before i was done i ended up on my bu#3#in the yard .
    i am kinda freekin out because i think he is going to tell me to do the fusion witch i really don't want to yet (i can still walk kinda)
  • I will do that. tee he hee , i just love that ;) .
    the thing that is not funny is you may be better than some of the doc's i have seen ,
  • had mri today talked to the teck about contrast he say sometimes don't need it just maters what the doc is looking for. no biggie,
    so 10 min into the test he say i should prob do the contrast to really get some good images and a complete test ? i told him ok .
    ok what the ##### he would not tell me if he saw something or not he say it would be in the radiologist report and i would need to talk to my serg about it.
    the disc and report not ready till Friday .
    i do not no if they just looking for more money or what. the place is fairly new and highly recommended. and now i have to wight till Friday to have Z06 to tell me exactly what my problems are and how to fix me .tee hee hee :))( :''(
  • Hi John,

    Glad to hear you got your MRI done. As to the technician doing the test, *most* facilities won't allow them to interpret your MRI as they are not doctors. I've only had one where the radiologist was in the control room, and he did give me a brief on what was going on, but that is rare.

    As to contrast. My take from my many MRI's is especially when you have hardware, it allows the soft tissue and scar tissue to be more clear (brighter). For me too on my last surgery, it showed (thanks to contrast) that I had inflammation in my vertebra. Yep, it depends what the doctor or surgeon is looking for... :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • John,

    A couple of things.

    If the tech came back in the room and told you with contrast would be better. I'd venture to say 1 of 2 things happened. He may have seen the imaging was not very clear in some areas and wanted them highlighted better. Especially when it is surrounding the problem discs. The other is yeah, they are milking it. I've used the same hospital for my imaging to be consistent and I trust they would not do that.

    As far as you not wanting surgery, well, none of us really do. The timing is never good. One thing you might want to keep in mind. You can always try and delay it and take pain killers or get ESI shots. Just make sure that if the discs are really that bad and the surgeon is pushing for fusion. You confirm that it won't cause additional damage not doing it right away. I held off after the microD failed. Tried PT, meds, shots, praying, beating a rubber chicken, etc... I was told that most likely a few months delay was not going to cause additional nerve damage. In some that is not the case. Permanent nerve damage sucks. You want to minimize the other stuff, besides having whatever the surgeon suggests you do. If he says fusion then get another opinion from a surgeon in another office. I ended up getting fused.

    If all else fails send me the MRIs and I'll tell you what is wrong and what surgery to get. That way you can just tell your surgeon and save him figuring it out. I'm sure he'll be thrilled, not.... ;-)

  • ya i did-or do have lots of scar tissue around l5 area that's what i was thinking why he wanted the contrast.
    This is my 3rd surgeon he say i could prob put off serg for a wile or for ever with out more permanent damage as long as we could find something to get the pain under control. the first and 2nd wore not so sure and wanted to do the fusion right a way.
    what i took from them was i was kinda in the middle ground any worse need surgery any less just find a way to live with it. The 2nd surg say just do it now and get it over with .(ok that's what i say for the first surgery)
    I still have numb back of leg,caff,heal, witch i dont think will ever come back . and yes i am getting really tired of the roller coaster ride and maybe just let them remove it and put a metal post in and be done 8}
  • I got it early (back to banging head on wall)
    no sing of disc tear this time,
    just herniation L5-s1 and L4-5(maybe i can have a revision instead of fusion now)
    but there is always a but i am back to the scar tissue game.
    also shows granulation tissue in spinal canal and on or around s1 nerve (crap)what is scar tissue doing in my spinal canal ?(i looked at mri and i do not see it)you think with my 2 years of mri reading i would see it (i think i will post my images so a complete stranger on the internet can tell me what to do ).
    so off to the surgeon .(round and round we go)wow i am winy some of you have been doing this for ever.
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