Conversation: The conversation between human and AI assistant.
[|Human|] ive had a lumbar fusion L5,S1 i had some leg pain prior to doing the fusion now i am in chonic pain everyday lower back and down both legs ive had needles to try to help dodnt work i have a spine stimulator in me that does nothing at all. my dr. gives me morphine er 60 mg 3 times a day & its like eating candy doesnt do anything but he doesnt change my meds or try to help me i am in tears everyday cause of the pain now he wants me to have a post cat scan myelogram i dont really want to do this test cause i have to be awake for the needle going into my back what does this test show that an mri or cat scan doesnt show?
[|AI|]  Hi there, thanks for your question. Managing persistent pain post fusion surgery in indeed a very difficult and uphill proposition for both patient and treating doctor. Post fusion surgery due the the position of screws the routine MRI and CT scans are marred by artifacts by the screws. Most of the time it is not possible to ascertain all findings and assess severity of stenosis by these investigations. This is where CT pyelogram helps us spine Surgeons since the artifacts are less and severity of stenosis can be assessed independent of the screws. The injection in your back is essential to inject contrast fluid into your spine which will line up or light up the areas of interest. Definitely It's difficult to have a needle inserted in a painful back, but it some of the ways forward to know what's causing your pain. Hope this helps. All the best. Regard.  Chat Doctor.