Do teenagers have MRI's prior to Scoli Surgery? Please give input....

[asccbodypro]

I know someone who's teenage daughter is having Scoliosis Surgery and the doctor was going to move forward with scheduling her surgery until she mentioned that her back hurts and she suffers from frequent headaches. Having undergone surgery myself I cannot fathom that a doctor would skip this very important step despite her age. Are things different for kids than they are for adults? I appreciate feed back as soon as possible!!!

[titaniumed]

GP’s are the gate keepers for the insurance companies....You usually have to start with them first. They might order x-rays as they are the next step, the next “economical step” in the process. After one goes to a specialist, he will shoot his own x-rays and start talking about surgery or avoiding surgery. Many good surgeons will try to avoid surgery by doing alternative methods. Surgery is expensive and insurance companies don’t like writing big checks.

If there is no getting away from surgery, then the next steps usually take place. The bending x-rays, and MRI’s, usually come next......MRI’s are pricy. The newer machines are getting quite expensive......It all part of an economical, medical, chain of events, dictated by insurance companies.

On the subject of CT’s, these should be last in line, usually only if there is some sort of problem since they emit large doses of radiation. You don’t throw kids in these machines on a whim. Cancers usually take time and kids have more time than the adults.

Ed

[asccbodypro]

Hi Ed! Hope you are doing well. Its been a long time. This appointment was with the surgeon. It was to be her appointment where they would schedule her surgery. They did do more x-rays that included her bending x-rays. I was just very concerned to hear that no MRI being ordered UNTIL she complained of back pain and head aches. While I'm not sure of the degrees of her S curve she was told that she missed her chance of bracing and she was immediately sent to the surgeon. I just feel that a surgeon so willing to skip these steps regardless of whether you like him should be avoided at all cost. Since we have military coverage and my surgery was at a military hospital I'm certainly no expert of what is and is not covered these days. Very good point on the CT Scan and I'll pass that along. I should have known that. My son had numerous scans due to an illness and they were not given lightly. Thanks again!

[asccbodypro]

Let me clarify: The doctor was not going to order an MRI at all prior to surgery. Just sounds like an unusual practice to me!

[Karen5]

Our daughter was just diagnosed in August at 11.5, and she had an MRI, not because of the back pain (which she does have), but because her curves progressed to 84*/91* in a year's time. Our surgeon said he needed to rule out underlying issues that might account for the fast progression. They did ask about whether she has headaches, and she doesn't unless her glasses prescription needs to be updated. They also asked a variety of other neurological questions like whether she was having pains, numbness, or tingling in her legs, trouble going to the bathroom or having accidents, none of which were issues for our daughter. Our doc was looking for 4 different possible things, the biggest/most common of which was tethered spinal cord. I don't remember the names of the other possible issues, but thankfully, she had none of them.

Our progression for appts/imaging/referrals went something like this:

1) Pediatrician evaluated and referred for xray that day and to spine doc appt which was 2 months away initially
2) Xrays taken, spine doc appt moved up based on severity shown on xrays
3) Spine doc appt where another xray was taken and referral made for MRI
4) MRI done
5) Follow up from MRI with spine doc and more xrays taken including bending right, bending left, and xray done under traction

There will also be a pre-surgery appt where they do labs and another xray. Hope that info helps.

[Karen5]

Let me clarify: The doctor was not going to order an MRI at all prior to surgery. Just sounds like an unusual practice to me!

I think I was posting at the same time you were! I'm new to all this, but I got the sense that an MRI would be indicated for big/fast progressive curves and/or if there were neurological symmptoms.

[Pooka1]

I think I was posting at the same time you were! I'm new to all this, but I got the sense that an MRI would be indicated for big/fast progressive curves and/or if there were neurological symmptoms.

That is my experience and understanding also.

I have identical twins who have been fused. Only one girl had an MRI and that was because she had fast progression, 5* a month, for the entire observation period. The other girl did not have an MRI because her curve moved fast but not that fast.

I don't think they order MRIs if they think it appears to be straightforward AIS.

[asccbodypro]

That is very reassuring to hear! This young lady's curve was diagnosed in middle school as very mild. She was not followed for her curve until just recently. I will pass along this information. Thank you, Sharon!

[LindaRacine]

My understanding is that MRIs are typically ordered for kids if there is anything unusual, which would include left thoracic curve, pain, or a very rapid progression. If it were my kid, I would probably want her to have an MRI.

[asccbodypro]

My understanding is that MRIs are typically ordered for kids if there is anything unusual, which would include left thoracic curve, pain, or a very rapid progression. If it were my kid, I would probably want her to have an MRI.

If it were my child I would request an MRI as well, Linda. My son just had Pectus surgery back in June. I more than asked my share of questions and his doctor sent him to a number of specialists fist. Which made this mom feel good! I can't imagine the degree of questioning that would have went into that appointment had it been a Scoli correction. Thanks for the added info, I appreciate it!

[1998golfer]

I'm 18 now, had surgery 2 weeks ago tomorrow, and my surgery was done by a pediatric surgeon, and the only things they did were x-rays. Never even mentioned an MRI or other types of scans or tests. I only had 2 x-rays before scheduling the surgery, the first in July 2015 at 40°, and the second at the end of march in 2016 at 47°.

[kennedy]

I had a mri five years before my back surgery to rule out several things due to a congenital foot disorder. Characteristics for both Congenital scoliosis and idiopathic scoliosis.