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CAT Scan, MRI Scan and Myelogram for Back Pain & Leg Pain

Simon in Aylesbury, UK, asks:

"I have just returned from long awaited appointment with a neurosurgeon - I have had back pain which goes down my leg for nearly two years. He is sending me for an MRI scan and CT scan, and a myelogram. He didn't explain exactly what these were and I felt a bit stupid asking as he seemed to be in a hurry. Could you tell me more about these tests?"

Colin Natali, Consultant Spinal, Trauma and General Orthopaedic Surgeon at the back2normal back and neck clinic, London, replies:

"An MR, MRI, magnetic resonant scan or a magnetic resonance image are one and the same thing. It is a scan that doesn't use x rays and allows the spine, the nerves and the soft tissues (i.e. intervertebral discs) to be seen clearly. There are two types, an open one which is used for claustrophobic patients and a closed scan that is for the majority of patients. YOU MUST NOT BE PREGNANT, HAVE PACEMAKERS OF ANY SORT OR METALLIC OBJECTS IN YOUR EYES OR BRAIN - IF IN DOUBT ASK! Occasionally, if you have had a previous operation, an additional MR scan using dye injected into your vein may be performed.

"A CT or CAT are the same things. It stands for Computerized Tomogram or Computerized Axial Tomogram. It does the same as an MRI but uses x-rays instead of a magnet. This scan shows better definition for bones, but less good definition for the soft tissues, such as nerves and discs. YOU MUST NOT BE PREGNANT, AND MUST NOT BE ALLERGIC TO IODINE FOR THIS TEST - AND YOU SHOULD LET YOUR DOCTOR KNOW IF YOU ARE..

"A myelogram is perhaps the oldest method of imaging the nerves and involves injecting dye (which is clear to our eyes but shows up on x-ray, into the spine. X-rays and or a CT scan is then taken to see where the dye might be held up. (Rather like seeing a traffic jam on a road and then seeing a few cars going through the road works). YOU MUST NOT BE PREGNANT, AND MUST NOT BE ALLERGIC TO IODINE FOR THIS TEST.

"I would like to add that you should not feel silly when you ask your doctor questions. I ask my mechanic what he is going to do to my car and he explains it nicely as he knows I know nothing about "cam belts" and HT leads. In fact he enjoys answering the easy questions. Please ask your doctor - we do understand. After the scans it is VERY important that you ask your doctor what the results are and that you understand this before coming to a joint decision on treatment - it is your body after all.

More about Colin Natali >

Article published: 25th March 2004

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