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What Is The Best Technique To Diagnose Spinal Disc Issues?

Posted on Fri, 14 Oct 2016

Question: what is the best imaging technique to show what is happening at disc spaces and spinal nerves below a harrington rod (my sister's harrington rod is from T2 to L4; approx 40 years ago; she disc problems at the levels below)

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer:
MRI is the best imaging technique.

Detailed Answer:
Hi,

Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.

For clarity of discs and nerves, MRI imaging is the best imaging technique. There may be a bit of distortion of images at the level of Harrington rod (T2-L4). You can try to get MRI done at lower Tesla, such as 0.3 T or 0.5 T. With modern MRI of 1.5 T or 3 T, distortion of images may be more.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (43 minutes later)

Thank you. I don't know how this communication works, I have seen her MRI and the lower levels, below the rod, are VERY distorted. I don't know what the tesla rating was. Can modern MRI machines be set to do a lower tesla level scan; would a SPECT scan be more useful especially in determining the state of the facet joints? What surgeon in North XXXXXXX would you recommend for a consultation for someone like this?

Answered by Dr. Sudhir Kumar (4 minutes later)

Brief Answer:
Modern MRI machine can not do lower Tesla MRI

Detailed Answer:
Thank you for getting back.

An 1.5 T or 3.0 T MRI machine can not be programmed to do lower Tesla (0.3 T or 0.5 T) MRI.

Yes, for studying the joints, Technitium bone scan or FDG-PET (more expensive, so not routinely performed) can be used.

You need to consult a Neurosurgeon or a spine surgeon for this problem.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (53 minutes later)

Thank you again. I know this may not be possible, but are you able to suggest a (short) list of surgeons (or surgical programs/hospitals) in North XXXXXXX who have known expertise in dealing with complex post-scoliosis problems like this? I am having difficulty finding a specific specialist that she can be referred to. (I am in Canada, but am willing to try to help her see someone in the USA if necessary - financially, we can't go overseas). If you can't offer this kind of specific information, do you have any idea how I can narrow the search myself?

Answered by Dr. Sudhir Kumar (6 hours later)

Brief Answer:
Link is given below.

Detailed Answer:
Thank you for getting back.

There are several good centers with expert surgeons in USA. I agree I do not know any surgeon personally, however, I am providing the link below with the rankings:

http://health.usnews.com/best-hospitals/rankings

You could choose any center within the top 10 rankings of neurosurgery/orthopedics.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar