Traditional spine x-rays are our oldest imaging option but still provide valuable information about spinal alignment, scoliosis, the degree of spinal arthritis and disc degeneration, as well as the quality of the bones. Using Flexion/Extension views we can help determine the mechanical stability of the spine. We can also follow the progress of cervical and lumbar spine fusion.
Magnetic Resonance Imaging (MRI) is our newest and most advanced imaging option providing an almost photographic image of the area studied. Although most of the body enters the tube, only a specified portion is studied, e.g. the brain, cervical spine, thoracic spine, or lumbar spine. The study provides good visualization of soft tissues structures like the brain, spinal cord, spinal discs, and is very useful for diagnosing infection and tumor. Unfortunately the image resolution and quality especially with spine studies varies with the cost of the machine, the size of the opening (bore), and the size of the patient. Open (bore) MRI machines should be used only in patients with extreme obesity or extreme claustrophobia. MRI usually is not an option in patients with pacemakers, recent cardiac stents and certain other types of metal implants.
Computerized Axial Tomography provides cross sectional and 3D images of the area studied. It is less expensive than MRI, is excellent for studying the bones of the skull and spine, and is good for brain studies. CT is not as useful as MRI for visualizing the spinal cord and spinal discs. CT is commonly used with a myelogram to improve visualization of spine pathology.
Electromyography (EMG) involves placement of small needles into the spinal muscles and arm or leg muscles to evaluate the electrical response to muscle contraction. Nerve Conduction Velocity measures how well the individual nerve conducts a small amount of electrical current. These studies are useful in the evaluation of a pinched nerve in the neck or back (cervical and lumbar radiculopathy), a compressed nerve at the wrist or elbow (carpal tunnel syndrome and ulnar neuropathy), or a diseased nerve, e.g diabetic peripheral neuropathy.
This procedure is usually done in the lumbar spine. Using local anesthetic a small needle is place into the spinal canal. A small amount of radiographic dye is placed into the spinal fluid space, and then x-Rays are taken. The procedure is usually followed by spine CT scan.
This procedure involves placing a needle into one or more spinal discs and injecting radiographic dye. The patient is asked to compare the pain response of each disc injected to their normal pain quality and distribution. CT scan is usually performed after.
This procedure involves IV injection of a small amount of radionuclide material with subsequent whole body imaging. The test is useful for evaluating bone and disc space infection, areas of inflammation, compression fracture, and metastatic spine tumor.
For additional information about these and other diagnostic tests, please visit AANS.