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Thread: MRI Questions

  1. #1

    Question MRI Questions

    I am new to this forum but posted a couple of questions a few weeks ago. In March, I had a major pelvic injury, which included a sacral fracture that required an illiosacral screw to stabilize, as well as a plate in the front of my pelvis. I now have several issues, including urine retention, severe constipation and ineffective emptying of bowels, loss of sensation in the perineal region, my leg falling asleep and going out from under me when walking more than a minute or so, and severe lower back pain with the feeling of an electric current running through it. I saw my doctor today, and I really thought that he was going to say he believes I had nerve damage in the sacral area. Instead, he is sending me for an MRI to check for a possible missed spinal cord injury of the L 4 - 5. I have a few questions.

    1. Will an MRI of my lumbar show any damage, if there is any, in the sacral area also?
    2. Would the illiosacral screw obscure the view of the sacral region where nerve injury may have occurred, if the problem is there, instead of the lumbar?
    3. If there is nerve damage, will an MRI be a definite diagnosis? In other words, if the MRI is negative, does that mean that I, for certain, have something else going on?

    I am so glad you guys are here. My family basically seems to think that I am just not thinking positively enough (as if that would just make everything go away?) and my GP seems confused. My rehab doctor who I saw today is the only one who has seemed to take this seriously.

    I sincerely appreciate any input, as I am brand new to all of this!

  2. #2
    An injury to the cauda equina (sacral nerves inside the sacrum, cauda equina syndrome, CES) can look very much like damage to the conus (the lowest tip of the spinal cord); many physicians don't even try to determine which it is when they seen these types of symptoms since there is really nothing they can do to correct the damage once it occurs. An MRI may show damage, but it also may not. If trying to determine that damage is in peripheral nerves vs. the cord, an EMG type of study called an SSEP (somatosensory evoked potential) study may also be useful.

    Your rehab physician should be able to set you up with an appropriate rehab program that includes learning how to manage your bowel and bladder, getting sexuality education and counseling, and management of any other associated problems. Is this rehab doctor a physiatrist (specialist in PM&R) and are they also a sub-specialist in SCI? If not, you may want to ask them to refer you to someone who is.


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