Trombone in the MRI

hyperbolica · by **hyperbolica** » 2024-09-14 8:03 p.m.

Trombone makes the news

Man plays trombone during brain surgery

<LINK_TEXT text="https://www.cnn.com/2024/09/14/health/v ... dnt-digvid">https://www.cnn.com/2024/09/14/health/video/wdjt-trombone-brain-surgery-affil-dnt-digvid</LINK_TEXT>

AtomicClock · by **AtomicClock** » 2024-09-14 9:28 p.m.

Wouldn't work with an open wrap.

hwlentz · by **hwlentz** » 2024-09-14 11:30 p.m.

My son in law is the surgeon that did the operation and is interviewed in the clip. He told me about this and mentioned that they had him hold the horn and move the slide, but not to actually play. - something to do with building pressure during the surgery.

hyperbolica · by **hyperbolica** » 2024-09-15 8:48 a.m.

[quote="hwlentz"]My son in law is the surgeon that did the operation and is interviewed in the clip. He told me about this and mentioned that they had him hold the horn and move the slide, but not to actually play. - something to do with building pressure during the surgery.[/quote]

Interesting to have a connection like that.

About the tbone, if you play at that up angle the spit will roll back in your mouth.

BGuttman · by **BGuttman** » 2024-09-15 9:02 a.m.

Did they actually use an MRI? There are some steel parts in the trombone that could affect the MRI machine. I had to remove all jewelry, and any clothing with metal (like a belt) when I underwent my scan. To play in an MRI I would suggest using a plastic instrument.

I couldn't watch the video; just read the caption. Opening picture did not look like an MRI.

Incidentally, this is a great way to correct essential tremor. Have the patient do things that cause the tremor while probing.

Burgerbob · by **Burgerbob** » 2024-09-15 10:47 a.m.

There's an MRI scan that they show, and ALSO brain surgery, but not both at the same time. Still pretty impressive to play during surgery- I think maybe I'd bring my bass trumpet instead!

hwlentz · by **hwlentz** » 2024-09-15 5:40 p.m.

I think OP may have meant OR (operating room) rather than MRI. As I understand it* patient had something called ‘intention’ tremor, which is similar to essential tremor but occurs and interferes when you’re trying to make an intentional movement.

*I’m not licensed to practice medicine anywhere in the world. ;)

Posaunus · by **Posaunus** » 2024-09-15 6:24 p.m.

I just looked at the photo and video. That's no MRI device, which (as Bruce noted) could not be used while playing the trombone. It's just a plastic hood over the patient's head in the operating room to separate the sterile field for the surgeon to manipulate his tools. Any MRI scan would have been done before (and possibly after) this procedure, in a much more imposing piece of machinery.

<LINK_TEXT text="https://my.clevelandclinic.org/health/d ... maging-mri">https://my.clevelandclinic.org/health/diagnostics/4876-magnetic-resonance-imaging-mri</LINK_TEXT>

BrassSection · by **BrassSection** » 2024-09-16 12:42 p.m.

I guess some metal is ok in the MRI chamber. After having my right knee replaced, 5 weeks later I had an MRI on left knee prior to surgery for getting measurements to size the replacement joint for my left knee. Right leg with metal was in the chamber.

I did get a letter from the MRI staff noting they observed something wrong in my left knee and that I should consult a doctor. Like a surgeon would have sent me for that scan if he wasn’t already planning on replacing the knee??

JohnL · by **JohnL** » 2024-09-16 1:46 p.m.

[quote="BrassSection"]I guess some metal is ok in the MRI chamber.[/quote]
Non-magnetic metals and alloys should be OK - but it's better to be safe than sorry, and expecting people to know whether a specific object is magnetic or non-magnetic is probably asking a little much.

BGuttman · by **BGuttman** » 2024-09-16 2:39 p.m.

One surprising issue with MRI scans is tattoos. Older tattoos used inks with iron pigments and these would react badly to the magnetic field. I've heard that iron pigments will vibrate so strongly they create hot spots and can burn the skin around them. I don't know if modern tattoo inks have the same problem -- given the high prevalence of tattoos I see on younger people I suspect not. Otherwise we will see a major demise in using MRI as a diagnostic tool.

tbdana · by **tbdana** » 2024-09-16 3:31 p.m.

Is there a similar procedure that can make me play better?

dwcarder · by **dwcarder** » 2024-09-17 1:00 p.m.

That's my friend Brian! We played together for various functions, one of which sort of spun off into a local horn rock band he's doing regular gigs with. I just saw him earlier this year, and post-surgery is going amazingly well thanks to this amazing technology that keeps the tremors under better control.

The case study I'm aware of was published earlier this year:

<LINK_TEXT text="https://pubs.asahq.org/anesthesiology/a ... Awake-Deep">https://pubs.asahq.org/anesthesiology/article-abstract/140/3/585/139609/Intraoperative-Trombone-Playing-during-Awake-Deep</LINK_TEXT>

"In this case, a 65-yr-old man with bilateral essential tremor underwent awake deep brain stimulator placement targeted to the ventral intermediate nucleus for symptom management and improved quality of life. The patient’s primary complaint was that the tremor affected his ability to play the trombone.

Initially his tremor was managed with oral medications, but, as their effects waned, he struggled to hold his horn steady and felt as though his hands were fighting each other. Because his ability to play the trombone was a key factor in his decision to pursue deep brain stimulator placement, the patient asked if he could bring his trombone to the procedure, to ensure there was symptom improvement after lead placement"

mrdeacon · by **mrdeacon** » 2024-09-18 11:56 p.m.

Larry Zalkind’s experience having deep brain surgery to help treat focal dystonia is a fascinating listen.

https://anthonyplog.com/podcasts/larry-zalkind

hwlentz · by **hwlentz** » 2024-09-21 7:06 p.m.

Turns out our friend made the Colbert show;

(should load at the right spot, if not, it’s at 3’34”)

<YOUTUBE id="0DS2N4EkTu8" t="210">https://www.youtube.com/watch?v=0DS2N4EkTu8&t=210s</YOUTUBE>

elidoesmusiciguess · by **elidoesmusiciguess** » 2025-05-22 2:21 p.m.

[quote="tbdana"]Is there a similar procedure that can make me play better?[/quote]

From my experience, lessons with a really good teacher can feel like they're performing surgery on your brain :lol:.

jonathanharker · by **jonathanharker** » 2025-06-12 6:15 p.m.

For more MRI trombone goodness, Doug Yeo got himself recorded in an MRI playing his trombone somehow. I'm not sure how that works with all that metal...

Update: from Doug's post: "no ferrous metal can be in the scanner room because of the powerful magnets that are used to create the MRI images; therefore, non-ferrous brass bells must be constructed. A brass instrument bell is then connected to plastic tubing and a plastic mouthpiece"

<YOUTUBE id="KdFPYojfkF8">https://www.youtube.com/watch?v=KdFPYojfkF8</YOUTUBE>

<LINK_TEXT text="https://thelasttrombone.com/2017/08/22/ ... y-project/">https://thelasttrombone.com/2017/08/22/seeing-the-unseen-trombone-playing-through-the-eye-of-a-mri-scanner-with-the-mri-brass-repository-project/</LINK_TEXT>

harrisonreed · by **harrisonreed** » 2025-06-12 8:53 p.m.

But the only ferrous metal in the bell would be the steel bead, right? Mouthpiece is made of copper, zinc, silver, and lead.

BGuttman · by **BGuttman** » 2025-06-12 9:58 p.m.

From an article by Stanford Research Group on effects of metals on MRI:

The presence of metal can be a serious problem in MRI, because (1) Magnetic metals can experience a force in the scanner, (2) Long wires (such as in pacemakers) can result in induced currents and heating from the RF magnetic field and (3) Metals cause the static (B0) magnetic field to be inhomogeneous, causing severe image degradation.

This means copper wires are a problem and even non-ferrous metals can cause anomalies in he scan.

Note that all MRI movies of Willis and Yeo were made with glass or plastic mouthpieces. I would assume that plastic tubing connected to a bell somewhat removed from the scanner.

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Trombone in the MRI