My Neurosurgeon

Sat, 10 Jan 2026 00:00:00 +0000

I was doing a ride-along with a friend of mine who works for a suburban police department. It was a call for an elderly lady with back pain. We were the closest unit and arrived before EMS did.

The patient was about 80 years old, lying in her bed fully dressed, simply waiting for the ambulance. She had a history of prior back surgeries and reported that she had “broken rods” in her back. She was scheduled to have another surgery in a couple of months. She had a back brace and her rolling walker at the bedside. She was very calm and reasonable. She did not have any pain at rest, but she said it hurt too much to move, so that’s why she wanted to go to the hospital. There was no report of any new trauma.

MRIs in the ER

Sat, 06 Sep 2025 00:00:00 +0000

There are only 2 MRIs that typically need to happen in the ER. Brains and spinal cords. There are virtually no extremity MRIs that have to happen emergently. I see patients regularly that have things that could be diagnosed on an MRI… rotator cuff tears, meniscus injuries, torn ACLs. But none of those things need emergency surgeries so they don’t need emergent MRIs. Patients often come to the ER within minutes of a knee injury and they may very well have a torn ACL. But I don’t have to find it immediately. No Ortho surgeon is rushing to the ER to fix it. You would not want them to in most cases. For things like rotator cuff tears and minor tendon or ligament tears, the first line of treatment is physical therapy and pain medicine. This is referred to as “conservative therapy”. Most of the time, this resolves the problem. Surgery is something to consider when conservative therapy fails. It is not the thing that has to happen immediately upon finding an injury.

Neurosurgery on Paul Nystrom

My Neurosurgeon

MRIs in the ER