[SpinelessWench]

#6874

Dr. Corenman,

In the next few weeks, I’ll be undergoing implantation of the Medtronics spinal cord neurostimulator as a pain management option. Should my pain levels not improve >50% during the trial period, we plan to move forward with the Medtronics morphine induction pump. Given neither device is compatable with current MRI imaging technology, I have the following questions:

1. Should I ever rupture another disk, or develop symptoms warranting imaging of my lumbar or cervical spine, are CT scans reliable or accurate enough to detect nerve root compression, foraminal or canal stenosis, annular tears, HNP, etc?

2. While Medtronics spine implant devices are compatable with conventional X-rays, fluoroscopy, and myelography, these modalities aren’t conducive to a surgeon’s ability to detect more intricate anomalies associated with DDD, DDJD, and similar conditions…so;

3. If you had a patient (hypothetically) with an implanted pain-control device, and that patient developed symptoms warranting diagnostic imaging beyond X-rays, what would be an imaging technique you’d rely upon if MRI were negated?

As always, thank you for your time, advice, and suggestions.

S.W., NC

[Donald Corenman, MD, DC]

#6877

I actually see this problem all the time. Patients come into the practice with spinal cord stimulators, defibrillators and pacemakers that are incompatible with MRIs.

There is really no test that is as good as an MRI but the CT myelogram is a very close second. This test is excellent to detect nerve root compression, foraminal or canal stenosis and HNPs but not annular tears. The only disorders that CT scans are not excellent at diagnosing are annular tears and far lateral disc herniations. Far lateral disc herniations are rare.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[SpinelessWench]

#6878

Much appreciated…

FINAL QUESTION:

Clinical studies and trials are always ongoing… What’s a good online resource to which I can refer for possible participation? Or, do you know of any upcoming clinical trials whose focus will be implementing pain reduction technologies, conducting new surgical techniques, or testing newer implant devices in patients who’ve had multiple surgeries without success?

Those that pay participants $3.50 per hour and a bag lunch are also appreciated :)

Continued success in your practice.

S.W., NC

[Donald Corenman, MD, DC]

#6879

You would have to check with various universities and research programs to find that information out.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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