Lumbar MRI - what does it show?
 

I thought this may be a good place to ask since many of you have probably had MRIs of the spine. I have pressure in the middle of my back that causes pain, spasms, etc. I believe it may be from a B12 deficiency that has gone undiagnosed. Due to several other symptoms I am having, my Dr decided to send me to a neurologist first. This Dr ordered a MRI on the lumbar spine with no contrast. I'll also be having an EMG in a month.

Can anyone tell me what part of the spine the MRI will show? I know lumbar means lower back but does that mean below the shoulders? Will it show the middle of my back? Thank you so much!

Lumbar means the lower back -- it will NOT show the Mid-back. If you "google" "lumbar spine" and do a search on it, you'll probably find charts that show you different parts of the spine.

It's too bad your doc isn't ordering the MRI with contrast too -- that's usually better at detecting problems when it's ordered with and without.

If you get a report of the MRI for yourself (you CAN ask for it), and then post it here, we can explain it too you. Best of luck and I hope that nothing is seriously wrong. God bless & take care. Hugs, Lee

Thanks Lee! I called my Dr office & let them know what the Dr ordered & what my concern was & the girl said, no that will show your mid back. It shows a good portion of the spine. So I said, oh really? I thought lumbar just meant lower back but it will show the middle of the back also? and she said yes. Hopefully this won't be a waste of time. :confused2:

Regardless of what else is being done, could it hurt to start taking B-12 and see if you get any relief/improvement? I'm a little surprised your doc wouldn't order a B-12 test anyway, as it's a lot faster, easier, and less expensive than an MRI, but at the least he should be willing to discuss with you his reasons for the tests & order he's doing them.

A lot of people on this site take B-12 for many reasons. If you think you're really deficient, 5,000 mcg sublingual of methyl cobalamin/ day for a few months is a good way to go, then re-evaluate/adjust at that time.

Doc

I am on B12. I was diagnosed in June after 2 bad loss of balance spells. I've seen countless specialists for odd symptoms but nobody ever considered B12 deficiency. After this happened & I did research on my own, I told the Dr I wanted to be tested so he agreed. It came back at 163, very low. First month, I got weekly injections, now I am on monthly injections. My symptoms have worsened though.

If the doc ordered a "lumbar" MRI, it will NOT show the mid-back. I don't care what the girl at the office said. LOL I've had MANY lumbar MRI's and NONE of them showed the mid-back.

So I think the girl at the office was wrong -- but you'll find out when you get your report. Good luck & let us know what it says. Hugs, Lee ;)

Monthly injections are not enough for most people.

I suggest you use an oral product of active form B12 called methylcobalamin. Take 5mg daily orally on an empty stomach for best absorption.

We have had many people here on monthly injections which did now work well. They are cyano form and that is a synthetic and the injection only lasts 72 hrs in the blood. Taking it orally gives you B12 every day, so your body can respond in a more normal way.

Pennies a day... available online at iherb.com, Puritan's Pride,
Swansons, and Vitacost. Make sure you get METHYLcobalamin!

Have they retested yet, and if so, what are the levels at that time? Most injectable B-12, AFAIK, is cyanocobalamin, which not all people assimilate well (which could also explain the deficiency to begin with). Methycobalamin is ostensibly better assimilated and relatively inexpensive, but must be taken on an empty stomach. There's a lot more info about this on the B-12 discussion thread in the Peripheral Neuropathy forum:
http://neurotalk.psychcentral.com/thread85103.html

Were any other blood tests done (vit D? others?), and if you'd care to share the results (and the odd symptoms), some folks here may be able to offer some suggestions or other things to look into, or point to other resources to follow-up on your own.

Doc

Another thing to understand is that your initial test is very very LOW.... lab ranges in US are not accurate anymore and report levels in the 200's and "normal". Doctors then follow THAT without getting continuing education on the subject.

The thread linked by Dr. Smith is my thread, and explains this.

You should test above 500 to show benefit. You would have to wait a week after an injection to get a useful reading, as the injection lasts about 72 hours in the blood. Waiting a week may show more accurately. Doctors ASSUME every one should get monthly shots. But none of us are identical in the way be process B12.

B12 has to enter the spinal cord to get into the CNS. When blood levels are low, your cerebrospinal fluid is low, and this is very bad. MS and Fibro people have been tested in studies and typically show low B12 in the spinal fluid. The B12 in the CSF mirrors the blood and if your blood is very low, below 500, your CSF will be low too.

Pennies a day of a quality product that has no toxic upper limit?
There are not even drugs, this safe and inexpensive. You can take care of yourself in this regard, and only use the doctor for testing. Don't expect a clear interpretation by most doctors in fact. On my thread is a link the new medical information from American Association of Family Physicians. Please read that and you will understand this topic much better than most doctors today.

Thanks for all the replies! My first B12 test was 163, I did weekly B12 shots for 1 month & then went on monthly. I have been taking a B12 supplement on my own in between. After about 2 1/2 months, I was retested. I purposely went for the blood work the week before I was due to get my B12 shot to make sure I didn't have a spike in numbers from getting it too close to an injection. New number came back 408. This was encouraging to see the number was increasing. It still needs to go higher obviously but at least it's moving. I am scheduled for another test next month. I have read B1 has been shown to help nerves also. There is a version out that lasts longer in your system called Benfotiamine. Thinking about giving that a try.

I haven't had the MRI yet (waiting on insurance authorization) but I posted on another forum with doctors & an osteo. Dr. told me that the lumbar should be fine. I also asked a relative who just recently became a surgical assistant and he said in most cases you can see the mid back & that I should tell the tech where I am having some of the pain. So I am going to just have it done & see what happens. The pain changes. The pressure is always in the middle but sometimes the lower back is worse, today my lower back & hips hurt a lot. Other days the lower is fine & my upper back hurts. Today I got vibrations totally down my right leg, from foot to hip, after having to walk quickly somewhere a short distance.

Well, the Dr just wrote Lumbar MRI - no contrast, then he wrote some of my symptoms down so I assume that was an indication to the tech to capture areas that could be causing these issues

I don't understand your question. What do you mean "why am I not bringing it up now?" That was my initial question and I have had mixed responses as to whether it will or will not show it. These responses have varied from people within the medical community & out. So my general feeling is that there is no completely true answer. So I am going to have the MRI as it is written now & see what happens. If it comes up showing nothing and I feel the area I am concerned with is not shown, then I will raise that to either the neurologist or my family doctor.

In my case, I already primarily know the reason. I have been a vegetarian for over 20 years. But the symptoms started a couple years after I was placed on a PPI drug due to GERD. I think it's a combination from the lack of B12 in my diet & the reduced acid which further hinders absorption that has led to this. Since being on the PPI, I have discovered I am deficient in other vitamins also, like vitamin D. I have an appointment with my GI doctor in a couple weeks to discuss whether I should stay on the medication. My family doctor & I are working on getting the numbers up & then we will try just supplements, if my numbers begin to drop, then I may have to stick with injections for life.

Westgrl--
 

--you definitely should take a look at our Vitamin/Supplements forum:

http://neurotalk.psychcentral.com/forum49.html

If you truly do have deficiencies and need supplementation, periodic injections might not be the best way to go; you may get more effect from large scale daily oral supplementation. See the Vitamin D and B12 threads there.

And, yes, B12 deficiency can lead to compromise of the spinal cord known as subacute combined degeneration. B12 deficiency eventually affects a number of bodily systems, but spinal cord problems are fairly well documented in the literature.

And to my knowledge, a LUMBAR MRI may also include a few of the lower thoracic vertebrae, but it will basically concentrate on the lower third of the back (from T12/L1 downwards, perhaps to S1/S2--it generally doesn't get the pelvis or iliac spine, either).

The results of my MRI were clear. The Dr wanted films so I was able to see what is shown. I told the tech that I was feeling some pressure in the middle of my back. She wrote it down, from what I can see, it looks like the 2 discs above the lumbar are visible. I recently found out, purely by coincidence, that magnesium can sometimes help back pain if it's muscular. I go for the EMG on 11/4 so no harm in trying it before then to see if it helps at all.

I've noticed my eyesight gets blurry when I overdo it with my back. Walking too much, etc. Not sure what that could indicate. The MRI report said alignment is well maintained, everything is normal size & signal intensity, no suspect lesions, no disc bulge or herniation, neural formina are widely patent at all levels, thecal sac is unremarkable. Impression: Unremarkable MRI of the lumbar spine.