28.11.2020

X-ray of the spine: indications, contraindications, preparation and interpretation of results

The most common reason for purpose of imaging the patient are pain in the back and also spinal injury. If the doctor needs to urgently diagnose and study the condition of the spine patient, it is most likely to prescribe the patient an x-ray.

X-ray of the spine is one of the most simple and accessible methods of diagnosis, which, like any other methods of survey has its advantages and disadvantages.

What is x-ray examination?

X-rays pass through tissues of different species, differing in density: the higher the density, the more x-rays it holds. As a result, the x-ray bone depicted in light tones up to white, and tissue with lower density of gray.

Almost every clinic has at its disposal at least one x-ray machine. But it is worth noting that modern digital devices the pictures the first time almost always turn out good enough. In this case, skip the stage of manifestation, and the x-ray immediately comes to the computer screen. As for analogue devices with the old model, here, the pictures may be blurry, and in such cases the patient often has to undergo re-irradiation.

The advantages and disadvantages of radiographic examination of the spine

X-ray used in medicine almost a century, and today, despite the existence of other alternative methods of diagnosis, enjoys both doctors and patients, very popular.

The main advantages of x-rays of the spine include:

  1. The speed of the survey and obtain results. Because x-ray machines are available in almost every clinic, diagnostics can be carry out as quickly as possible. In emergency cases, the images are made in a matter of seconds, and the radiologist evaluates and describes the real situation for a few minutes.
  2. The availability and low cost of the procedure. If you compare x-rays with CT or MRI, then the price of the first diagnostic method essentially wins.
  3. The ability to record the survey results as a digital file. This gives you the ability to send the picture to describe an experienced specialist in another city or country.
  4. No need in preliminary preparation before many types of radiographic examinations.

X-ray diagnostics method also has several disadvantages:

  1. The impact of electromagnetic radiation on the body. Modern x-ray equipment is characterized by a high level of security, but still during the examination the human body is exposed to ionizing radiation, albeit in small quantities. That is why it is not recommended to produce x-rays of the spine often, and in some cases it is absolutely contra-indicated.
  2. The limited information content. If you compare x-rays with other diagnostic methods known to mankind to date, informative x-ray examination is slightly inferior. This is because x-rays easily pass through the intervertebral discs and soft tissue, so as to assess their condition with an x-ray is almost impossible. That is, for example, to determine the presence of intervertebral hernia by means of x-ray of the spine is impossible.

However, this diagnostic method is ideal for exploring the presence of:

  • fractures, cracks, and other deformities of the bony structures of the vertebrae;
  • growths osteophytes in this disease, as osteochondrosis.
Indications for x-rays of the spine

The main indication for appointment x-rays are pain in the spine.

Also the basis for the appointment x-rays of the spine can be:

  • often disturbing headaches;
  • a feeling of numbness and weakness in upper and lower extremities.

Depending on the localization of the pain syndrome and x-ray examination is divided into:

  1. X-rays of the cervical spine, which is assigned when:
  • the patient’s complaints of dizziness that usually bother when turning the neck or a quick tilt of the head;
  • pain in the region of the cervical.

Usually a radiograph of the cervical spine is performed in two basic projections. However, if there is need for additional data on the existing pathology, x-rays can be performed through the open mouth of the patient.

  1. X-rays of the thoracic, which is when the pain in the chest, which mainly occur at turns or tilts the upper body. The examination is carried out in three planes: front, back and in profile.
  2. X-rays of the lumbar is indicated for pain in the lower back.
  3. X-rays of the lumbosacral and coccyx

The last two types of x-ray examination of the spine is only possible after a certain preparation of the body. About the features of the preparatory process you will learn hereafter.

Preparations for radiographic examination of the spine

In General, for most types of radiography are not required to perform any special preparations. But if we talk about x-ray of the spine, before the diagnosis of such departments as the lower back and coccyx, the patient should be properly prepared.

So, in order to radiograph the low back and coccyx turned out in good quality, the study should perform the following activities:

  • adhere to diet prescribed by a physician;
  • to clean the bowel by an enema;
  • come in for an examination on an empty stomach.

Such requirements to the patient due to the fact that the accumulated gases in the intestine may become a major obstacle for x-rays, in connection with which the radiograph may be not clear.

In emergency situations where x-ray lower spine need to carry out urgently (for example, severe trauma), the patient’s bowel is prepared using only a cleansing enema.

If x-ray examination is planned, then the patient a few days prior to the procedure prescribed diet, the essence of which is the exclusion from the diet of all gas-forming foods (cabbage of various kinds, legumes, dairy products, potatoes, etc.).

It should be noted that according to some, the quality of the image is also perfectly reflected the appointment of a special enzyme preparations and active carbon.

Before proceeding directly to the procedure, the study should:

  1. To undress completely from the waist up.
  2. Remove all metal objects and jewelry with the examined part of the body.

During the implementation of an x-ray of the spine, the patient must:

  • be placed on a special table x-ray apparatus in the position which indicated a radiology technician degree, and which allows to provide the desired slope or curvature of the spine;
  • hold the position motionless time.
What pathology reveals x-ray of the spine?

Often to obtain the necessary information is enough radiographs in two projections:

  • studied is placed on its side;
  • studied is placed on the back.

For quality made pictures professional has the ability to diagnose the following pathology:

  1. Curvature of the spine of a different nature.
  2. Cysts, benign and malignant tumor.
  3. Changes in the structure of bone tissue of the vertebrae.
  4. Pathological changes of the articular surfaces of the vertebral bodies.
  5. The integrity of the spine – fractures, cracks, etc.

With radiographs it is possible to detect ailments such as:

Features x-rays of the spine with functional tests

X-rays with the use of functional tests is a fairly simple procedure that is widely used in medical practice for the study of pathological processes of the musculoskeletal system. To get more informative images during x-ray examination can be used for any additional component or condition – functional trial.

In General, functional tests can be divided into three types:

  1. Medical samples. In medicine, this type of sample is used most often with the ability to determine the functional activity of tissues or organs, as well as the feature of their work. Examination with the use of drug samples makes it possible to identify the reaction of the organism to a drug was introduced.
  2. Mechanical samples. This type of sampling is widely used in examinations of the musculoskeletal and neuromuscular systems. Thanks to such samples as fixation, load, flexion-extension of the spine or limbs, etc., can fully visualize the picture shows those areas which are unavailable in the normal position of the body.
  3. Contrast. The essence of this method lies in the use of contrast agents, allowing to show the visibility of those formations, the boundaries of which on a conventional radiograph can not be considered.

It should be noted that for greater reliability and informational content x-ray professionals often prefer to combine several samples simultaneously (e.g., drug trial, together with the introduction of contrast).

The harm of x-rays to the body. Contraindications

There is a common opinion that the radiation produced in the process of performing x-rays of the spine can have a negative impact on the body, and cause the formation of cancer cells. However, it is worth noting that this thesis has no scientific justification.

The level of radiation exposure received by a person during an x-ray of the spine, on the equipment of the old model is only 1.5 mSv, and this is when the x-rays in two projections. This figure equates to a proportion of the radiation that we receive a normal natural way for about six months.

According to science, dangerous dose of radiation a person can get one hundred fifty as a result of irradiation by the x-ray unit produced in one year.

Besides, modern digital equipment can produce images in a shorter time, and consequently with a lower dose of the organism studied.

But you should know that radiographic examination has contraindications:

  1. Pregnancy. It is proved that x-rays have a negative effect on dividing cells, and therefore can cause the development of various defects in rapidly growing fetus. Therefore, during pregnancy, especially in the first trimester, should avoid x-ray examination, and if necessary, choose more gentle methods of diagnosis.
  2. People with more weight. Here it is not so much about the dangers of the procedure, and that due to obesity, the pictures can be of poor quality, due to which the diagnostic results may be distorted.
  3. Patients with excessive nervousness. During the procedure, so people difficult to ensure maximum rigidity, and, consequently, the radiograph can get blurred. To solve this problem will help special drugs recommended by your doctor.
  4. The children’s age. Of course, if there is a reason even small patients x-rayed the spine. However, if possible, you should carry out a survey on modern digital x-ray unit with minimal radiation exposure.

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