Pain in the cervical and thoracic spine: diagnosis and treatment

Back pain bothers many people, but most people let this problem take its course, which subsequently leads to complications. If movements give you unpleasant or painful sensations, you should not delay a visit to the doctor, who will most likely send you for an MRI. In addition, examinations are prescribed before spinal surgery or to monitor changes after surgery.

We will look at what the examination is, what indications and contraindications it has, and what is included in the magnetic resonance imaging service in this article.

Features of MRI

Magnetic resonance imaging is one of the most accurate and safe methods for diagnosing diseases.

The method is non-invasive. It is based on obtaining visual information by exposing the body to powerful magnetic fields and high-frequency pulses, which are processed and displayed on the screen using a special computer system.

The result of the examination is a high-quality image in which the doctor can examine in detail the spine, internal organs, muscles and soft tissues, assess the condition of the intervertebral discs, nerve roots and spinal cord.

The procedure is much safer than an X-ray examination and more accurate than a CT scan.

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CT as a method for diagnosing the spine

This is a radiation method for examining the bone structures of the spinal column. A CT scan is often prescribed if an MRI reveals abnormal bone changes. Computed tomography is highly accurate in examining the bone structure of the vertebrae in certain vertebral segments. CT has the same limitations as radiography (not performed on pregnant women and children).

Ultrasound diagnostics

This is an absolutely safe method for diagnosing the spine, which allows you to obtain an image in real time. Most often, ultrasound is used to monitor the performance of punctures and biopsies. Ultrasound Dopplerography (for example, neck vessels) is used as a method for diagnosing the spine.

Electromyography

It is used in the diagnosis of diseases that are manifested by dysfunction of the motor nerves (neuropathy, compression and trauma of the nerves). Electromyography allows you to accurately determine the location of the affected nerve. During the study, thin needles are inserted into the muscles, after which the patient, at the request of the doctor, contracts these muscles, and sensors record electrical activity. The method is safe and causes virtually no discomfort.

In the State Clinical Hospital named after. A.K. Eramishantsev uses such methods of spinal diagnostics as radiography, CT, MRI. The clinic is equipped with the latest equipment (Toshiba Excelart Vantage Atlas-X 1.5 T, Toshiba Aquilion Prime, General Electric Discovery 670), tests are carried out by experienced diagnosticians. The contact telephone number of the neurosurgery department is listed on the website.

Contraindications

If the patient has metal implants, then the doctor must be warned about this at the first consultation. MRI is prohibited if the patient has:

  • cochlear implant;
  • built-in pacemaker;
  • intravascular metal elements;
  • metal plates, pins, screws, clips, surgical staples;
  • artificial heart valve;
  • neurostimulator;
  • limb prostheses or joint replacements.

In addition, there are some other limitations for MRI.

Thus, overweight patients (more than 120 kg) cannot be examined in closed-type capsules, since closed tomographs have technical limitations on the diameter of the tunnel and overweight patients may not fit in them. There is an alternative option for them: open-type tomographs, which can also be used to examine patients who suffer from claustrophobia.

Children, people with claustrophobia and people with increased nervousness are given sedatives before the examination, since any movement during the examination is prohibited.

For the same reason, patients with schizophrenia, Huntington's disease, Parkinson's disease, or other diseases that cause involuntary body movements may not have the procedure.

If the patient experiences pain, then before the examination he is given local anesthesia or anesthesia (depending on the condition).

Who is prohibited from MRI with contrast?

Intravenous administration of a contrast agent may be required before the study begins. Most often, it does not have a negative effect on the body, but certain allergies or bronchial asthma can be a good reason for refusing to administer contrast.

In case of kidney failure or other serious kidney diseases, the contrast agent may cause side effects or poisoning of the body. Therefore, such patients are prescribed a biochemical blood test, the results of which will determine the possibility of using contrast in the study.

Tomography with contrast is not recommended for pregnant and lactating women; it is prescribed only in cases where the benefits outweigh the possible risks. The final decision remains with the attending physician. If a nursing mother is still prescribed a test, then she must stop feeding for 24–48 hours after the procedure and express milk until it is completely renewed so that all harmful substances leave the body.

X-ray method for diagnosing the spine

X-ray allows you to obtain information about pathological processes in the spinal column, as well as track the dynamics of changes during therapy. The following X-ray methods for diagnosing the spine are distinguished:

  • plain radiography in two projections;
  • plain radiography in oblique projections;
  • plain radiography with functional tests;
  • targeted radiography;
  • layered x-ray examination (tomography);
  • X-ray with contrast (myelography, epidurography, pneumomyelography, discography, venospondylography).

The lowest radiation exposure is created by a spinal diagnostic method such as digital radiography. Unless absolutely necessary, X-ray examinations are not prescribed for children and pregnant women.

What diseases can MRI detect?

Magnetic resonance imaging will help the attending physician determine from the image the causes of pain in the back muscles. The following diseases may be the causes:

  • osteochondrosis and intervertebral hernia;
  • pinching of nerve endings;
  • spondylitis;
  • Bechterew's disease (ankylosing spondylitis);
  • arthrosis;
  • arthritis;
  • scoliosis;
  • muscle myositis.

Whatever the problem, a competent radiologist will be able to identify the disease using magnetic resonance imaging and write an explanatory report for the attending physician.

How to prepare?

MRI for back pain does not require special preparation or adherence to a special diet. Immediately before the examination, the patient must remove and deposit all metal objects that may affect the correct operation of the magnet: piercings, rings, chains, bracelets, earrings, watches, bank cards, dentures, keys, pens, belts, etc. If necessary, you are also asked to remove your everyday clothes before the examination.

Be sure to tell your doctor if you have fillings, braces, or tattoos, as there is a risk that heat may occur. The doctor must be prepared for such a situation in order to quickly respond if this happens.

If necessary, a contrast agent, sedatives or anesthesia are administered at the preparation stage.

How is an MRI of the back muscles done?

The study is carried out both on an outpatient basis and when the patient is hospitalized in an inpatient department. The patient is changed into a hospital gown (in some cases it is allowed not to change clothes if they are loose enough and there are no metal elements on them), placed on a retractable table, which is later pushed into a magnetic capsule. Using special belts and bolsters, the arms, chest and head are secured, since movement is strictly prohibited during the examination.

The device itself contains a two-way intercom so that the radiologist can talk to the patient, give him the necessary instructions, and also so that the patient can report changes in his condition, ailments, nausea, dizziness, difficulty breathing or any strange sensations . In such cases, scanning is forced to stop. But do not be alarmed by the sensations of slight tingling or warmth in certain areas of the body - this is considered absolutely normal.

Since the magnet makes quite a lot of noise, for the comfort of patients, headphones are most often provided to drown out the noise. Some models of tomographs have the ability to turn on calm music, which will not only relieve the patient from noise, but also help to calm down and relax.

All medical personnel must leave the room before starting the scanner.

How to save on MRI of the spine without losing the information content of the examination?

But, as promised in the title of the page, there are some “secrets”, knowledge of which will allow you to significantly reduce the cost of MRI of the spine and any other parts of the body without reducing the accuracy of the examination.

First of all, these are special price offers with the help of which diagnostic center managers optimize equipment utilization. It should be emphasized that when we mention discounts on MRI, we are not talking about “virtual” discounts, with which less technological examinations are offered on low-field tomographs, and not about discounts from “MRI factories”, where tomography is carried out, although with good equipment, but with an increased step ( distance between slices) and preparing a conclusion within 10-15 minutes, during which it is difficult to even briefly view the entire array of images.

We are talking about discounts on professional studies that allow you to attract patients during a decrease in activity on weekends, holidays and at night. For example, at the MIBS-Moscow MRI Centers there are regularly discounts from 5 to 15%, which subscribers of our account on Instagram and other social networks will find out about (icons at the bottom of the page). In addition, we provide special conditions for certain social groups.

Therefore, if you, like many thousands of patients, are already ready to choose the quality of diagnostics at MIBS centers in Moscow, but prefer to wait for a special price offer, subscribe to our groups. Or simply call us to find out how to undergo a high-quality MRI of the spine with maximum comfort for your own budget.

How long does the research take to complete?

Unfortunately, it is impossible to answer the question of how long it takes to perform magnetic resonance imaging of the back muscles, since the duration of the procedure depends on several factors:

  • the need for preliminary preparation and its complexity (administration of contrast, sedative, anesthesia or anesthesia;
  • the nature of the disease being diagnosed;
  • duration of recovery after completion of diagnosis.

On average, preparation and the tomography itself for pain in the back muscles take about 20–40 minutes. The recovery period depends on the sedatives or anesthesia used.

Data decryption

The data obtained is deciphered by a radiologist who specializes in conducting radiological studies and reading the resulting images. Only a highly specialized specialist will be able to understand what an MRI of the back shows. After a complete analysis of the images, a conclusion is issued, on the basis of which the attending physician will be able to decide on further actions and the need for treatment.

You can show the image with the radiologist's report to your attending physician either on the day of the procedure or the next day after the examination.

If poor images are received or doubts arise, the attending physician may order a re-diagnosis. Repeated examinations are also prescribed in order to monitor the pathology over time and to track the process of changes in the pathology during treatment.

  • MRI of the lumbar region.
  • Magnetic resonance imaging of the cervical spine.
  • Spinal examination - MRI or radiography.

Does it make sense to examine all parts of the spine?

There is no clear answer to this question. But there are often cases when the doctor needs to diagnose two or more parts of the spine within which the symptoms are localized (for example, MRI of the lumbosacral spine and MRI of the coccyx), or parts of the spinal column and the adjacent area (MRI of the craniovertebral junction, MRI of the sacroiliac joints). A complete examination of the spine (cervical, thoracic, lumbar, sacral, coccyx) lasts more than an hour.

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