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MRI Lumbar scan - am I the only one not getting this.

BobMiller90BBobMiller90 Posts: 4
edited 06/11/2012 - 9:01 AM in Back Surgery and Neck Surgery
Hello Everyone,
I am a sufferer of L4-5 and L5-S1 problems at present. In 2006 I also had C5-6-7 fused via the Solis Cage technique.

Recently, after 2 years of major problems in the Lumbar area, i underwent a L4-5 discectomy. Whilst the surgeon had me open he checked L5S1 and 'trimmed' there too and also shaved some of the lamina bone.

When i woke up i was in a bit of pain but after a few days I was feeling a bit better with absence of leg pain. Week on week thereafter I started to make good improvements until week 3 when i had a nasty UTI. Putting that aside as a possible complication of this type of surgery i continued to make progress until week 8 when i had to go back to the office. My office is a 3 hour round trip which i did on 3 days. The following day all my symptoms came back with a vengeance - pain at that level, muscle cramps up from that level, buttock, back of leg, calf front and back and cramps when controlling my foot. All back again as i was before. This was (is) very depressing.

I saw the surgeon again and he immediately scheduled a MRI on this Monday coming.

I have a question now on MRI's (eventually getting to the point of this comment!) as i have had 2 of them already and I think they are of little use.

Please consider this situation - when a automobile goes into the shop with a flat tire and is lifted up on the jacks (the type that lift the vehicle by the chassis) the wheels and tires are lifted off the ground. I saw a mechanic walk around a car prodding each tire and checking it as he could not, with the tires not being influenced by gravity, see which one was flat.

I believe that lumbar MRI's are essentially VERY limited in their diagnostic abilities due to the same reason - gravity.

If the surgeon or imaging specialist cannot see the effect of gravity and the weight of the body on the spine, then they cannot see what the disc is doing unless the spine problem is really bad.

I would have thought (and I am in no way an expert) that a scanner that allows the patient to stand vertically in the device so that the images are produced "in real life" would be of far more benefit than one where the patient is lying down, as in the above automobile analogy.

So am I the only one that struggles to understand why there aren't standing MRI scanners? (or a maybe I've just not seen them yet!)
Any comments would be appreciated.

Bob Miller
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Comments

  • Yes. Gravity makes for a great effect on imaging and seeing the loaded spine. Since it is still images taken of a body not in motion it is still of limited value. Just like X-rays.

    No. Gravity is not always the issue. Something may have gone wrong with your surgery. Xray is basic imaging tool for seeing skeletal structure and flaws. CT Scan takes Xray further. MRI is a basic tool for seeing muscular structure and defects.

    Today MRI is almost as common place as Xray and part of the process. There are sit down MRI scanners. You'll need to search as they are typically found in major cities and you would need your surgeon to agree to request that specific MRI device. Stand up scanners are just not there yet. The biggest problem with that concept. You. You have to stay perfectly still just like the laying down ones. Go ahead and tell a person to stand exactly still for 30 minutes. Exactly still! Oh and add that they have some medical problem with their spine when you tell them this. Good luck with those results ;-)

    After imaging comes functional tests. Like a discogram, myelogram, electromyography, and so on.

    You're in the first/second part of diagnosing why the surgery didn't work. With herniated discs and discectomy comes the first basic assumption. You reherniated or something is still pushing on the nerve. AS in he didn't get enough material out. That's why he added laminectomy also. He was trying to move bone away from disc to make even more room. First problem with laminectomy. They tend to cause instability.

    So your surgeon is troubleshooting. He's using the tools available to him in a structured order. Next time your in his office ask him about his troubleshooting process and what theories or assumptions he has made.

    Make more sense?
  • Hi Bob~ i had to laugh when i read ur post~ I also saw a need 4 vertical vs. horizontal lumbar MRI's.~ 90% of my pain came from functioning vertically.Had one year of physical therapy,2 numerous 2 mention injections B4 a 2 level PLIF surgery, & currently getting very helpful transforaminal epidural injections 4 residual pain.Went to visit my son in Boca Raton,Fl. & they have stand-up MRI's available!! I was incredulous! I could get specific address if u r interested. The epidural injections greatly reduce pain in the areas you are affected, as they have been for mine.

    Julie D.
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  • "I have a question now on MRI's (eventually getting to the point of this comment!) as i have had 2 of them already and I think they are of little use.

    Please consider this situation - when a automobile goes into the shop with a flat tire and is lifted up on the jacks (the type that lift the vehicle by the chassis) the wheels and tires are lifted off the ground. I saw a mechanic walk around a car prodding each tire and checking it as he could not, with the tires not being influenced by gravity, see which one was flat.

    I believe that lumbar MRI's are essentially VERY limited in their diagnostic abilities due to the same reason - gravity.

    If the surgeon or imaging specialist cannot see the effect of gravity and the weight of the body on the spine, then they cannot see what the disc is doing unless the spine problem is really bad."
    God, are you right about that "really bad" part.

    Sorry to hear of your problems. Maybe I can help you with your dilema. I'm new here to the site but know plenty about the back and back pain, but (I AM NOT A MEDICAL PROFESSIONAL) and have been dealing with spine issues since some brainless nutball hit my car 2006. I was 26 and he was 23 with crap insurance. I lived in chronic pain for nearly six years,still suffering and waiting for my own insurance company to pay my bills. Still waiting.It shouldn't be long now. I am about to drop the bomb on my attorney about my surgery and two week stint at a recovery hospital as soon as I know that he will get no benefit from these procedures. Why can he let my case drag so long? An upright MRI showed herniations at L4-5-5-S1 in 2007!!!! I had a lumbar diskectomy, facetectomy and foraminotomy on February 21. I am upset because all of your post surgery pains are almost the same as mine,and I DID have three sitting MRIs but the surgeon never saw them. I am on borrowed time as far as my L4-5. I also have a L4-5 disc that is broad based herniated.

    We agree on one thing- bad discs are like flat tires and weight bearing MRIs should be availiable at every hospital. They are not availiable at any hospital I know of.

    I had to travel a painful hour each way to get them but its worth it. I went to Upright MRI of Deerfield, Illinois. They have sitting and standing Mris,but a doctor must write a specific prescription for the MRI: sitting is more comfortable than standing in my experience for an hour, each MRI. Supposedly the "Fonar brand" mri uses a tesla magnet and is not as strong but I never had a problem-you just can't move at all. They must also specify which regions of the back are to be pictured and if the MRI will be flexion extension. The flex ex is a good option for finding instabilities in the vertebrae which are common causes of failed back surgeries in my belief. I have seen pictures of people who have them and a L4-5 that show "normal MRIs" laying down and when sitting up show vertebrae at 75 degree angles or worse to each other. I am only thirty two and have lost everything I had in my life. Once your back goes, life changes forever and any insurance company that thinks some piddly settlement could ever make up for all the opportunities, flexibility, and friends etc etc. that are lost is crazy!
    I had a flexion extension mri once, This showed three herniations, one at T2-3 Likely from the way my neck was turned I have had three total, all sitting, unfortunately my surgeons saw none of them before cutting. I did not have them with me at the hospital and worse yet the surgeons were not even interested in them!!!!!!!

    The MRIs are made by a company called Fonar and others, look on a search engine to see if there is a place in your area for upright or sitting MRIs. The sitting MRIs are very thorough. I have facet problems at every lumbar level, the opposite spondylolisthesis or backwards sliding vertebrae called a retrololisthesis that is not visible when lying down. Now my other discs, all lumbar discs are either bulging or in some other trouble. I was hit by two cars at a stop light with space in front of me luckily because I was at a poltce station. I was twisted to the right bent over trying to grab a CD case while telling a friend on a cell phone that I could not talk. BAM! A chevy impala behind me was hit by an oldsmobile and jacked the car off the ground. I was in a suburb really close to Chicago when it happened. 4:00 pm. I immediately had trouble turning my head and went to the ER after driving my suprisingly drivable car home and was given a neck colar. After that I spent a week in the hospital because the whiplash was first and soon I couldn't hold my head up it was a floppy as a newborn, along with general spinal pain.
    I am on a tremendous amount of narcotics and still feel horrid cramps in my left leg separately on the top and bottom that literally make me scream, and I am only 32. The steroid injections that were tried when I was first involved with a pain clinic did nothing except cause secondary adrenal and pituitary failure, one in every 300,000 gets this disease and a charlatan doc gave me way too many steroids and kept me in the hospital for a month and a half and fed me a dose meant for a fivehundred pound man. I gained 100 lbs within two months of leaving the hospital. I don't know myself anymore. All I know is pain, and tiredness because I am still trying to lower my hydrocortisone to a low dose which is impossible with all the swelling after the surgery. I was trying since fall of 2009 to drop on the steroids but without them I will die because I don't make them and other hormones naturally. They slow down recovery and at the rehab hospital I was sent to after I had surgery last month the doctor saw that I was struggling and increased my dose to double the normal without telling me. I am screwed. I got rid of half of what he added but can't go any further-my back literally eats them for breakfast! Enough about my pathetic life- I am 5'11 and used to look like Cameron Diaz's sister. Now, steroids have messed me up and made it harder to walk. Dr. got away with it too! Careful with steroids, they are poison.

    Hope you find an Upright MRI location near you
    I'm awake in pain if anyone wants to talk.
  • Hi Z06,
    Many thanks for your comments, this wbsite is very helpful and I have had 3 replies in less than 24hours. Thank you.
    I will ask about sit down scanners, they sound a step in the right direction. As for standing I can see why they would be problematic. Myself - I would be willing to stand for 30 hours if it meant a clear diagnosis. I am ex-military and have stood still for longer than 30 minutes on guard duty, so that would not be a problem. I would have thought some sort of cushioning, or foam inserts may have been an option, but as you say - we are not there yet.
    Yes - this make a lot more sense and thank you again for your comments.
  • Hi Julie,
    Many thanks for your comments, this website is very helpful and I have had 3 replies in less than 24hours. Thank you.
    If you can send me the name of the practice or the name of the scanner itself I would appreciate it, then I can look for them here.
    I have had a number of injections, the first worked, the other not really, hence the surgery. I was going great until driving my SUV, it all went down hill from there though.

    thank you again for your comments.
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  • Hi Tiffany,
    Many thanks for your comments, this website is very helpful and I have had 3 replies in less than 24hours. Thank you.
    I will try to find these sitting and standing MRI's. I think this is the way to go for me, my lying MRI's look ok-ish, but when i stand up i feel like i weigh 500 pounds - it feels like the weight is crushing my back. I too am trying to lose weight, but not being able to do any sort of cardio means I have to starve myself which isn't too much fun.
    Your accident sounds brutal, only someone that knows back pain can understand what you are going through - i find talking to healthy people pointless as they have no idea what is really going on. I also have watched all the activities I enjoy just go away - MTB, snowbaording, Harleys, evenwalking now is difficult.
    Anyway all we can do is go on and keep trying an not give up.
    thank you again for your comments.
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