Spinal X-Ray

Spinal X-rays are pictures of the spine. They may be taken to find injuries or diseases that affect the discs or joints in your spine. These problems may include spinal fractures, infections, dislocations, tumors, bone spurs, or disc disease. Spinal X-rays are also done to check the curve of your spine (scoliosis) or for spinal defects. X-rays are a form of radiation, like light or radio waves, that are focused into a beam, much like a flashlight beam. X-rays can pass through most objects, including the human body. Dense tissues in the body, such as bones, block (absorb) many of the X-rays and look white on an X-ray picture. Less dense tissues, such as muscles and organs, block fewer of the X-rays (more of the X-rays pass through) and look like shades of gray on an X-ray. X-rays that pass only through air look black on the picture. The spine is divided into four parts. So there are four common types of spinal X-rays:

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Cervical spine X-ray. This X-ray test takes pictures of the 7 neck (cervical) bones. Thoracic spine X-ray. This X-ray test takes pictures of the 12 chest (thoracic) bones. Lumbosacral spine X-ray. This X-ray test takes pictures of the 5 bones of the lower back (lumbar vertebrae) and a view of the 5 fused bones at the bottom of the spine (sacrum). Sacrum/coccyx X-ray. This X-ray test takes a detailed view of the 5 fused bones at the bottom of the spine (sacrum) and the 4 small bones of the tailbone (coccyx). The most common spinal X-rays are of the cervical vertebrae (C-spine films) and lumbosacral vertebrae (LSspine films). Why It Is Done A spinal X-ray is done to:

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Find the cause of ongoing pain, numbness, or weakness. Check for arthritis of the joints between the vertebrae and the breakdown (degeneration) of the discs between the spinal bones. Check injuries to the spine, such as fractures or dislocations. Check the spine for effects from other problems, such as infections, tumors, or bone spurs. Check for abnormal curves of the spine, such as scoliosis, in children or young adults. Check the spine for problems present at birth (congenital conditions), such asspina bifida, in infants, children, or young adults. Check changes in the spine after spinal surgery. How To Prepare Before the X-ray test, tell your doctor if you:

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Are or might be pregnant. The risk of radiation exposure to your unborn baby (fetus) must be considered. The risk of damage from the X-rays is usually very low compared with the potential benefits of the test. If a spinal Xray is absolutely necessary, a lead apron will be placed over your belly to shield your baby from the X-rays. Have had an X-ray test using barium contrast material (such as a barium enema) in the past 4 days. Barium shows up on X-ray films and makes it hard to get a clear picture of the lower back (lumbar spine). You don't need to do anything else before you have this test. How It Is Done

You will wait about 5 minutes until the X-rays are processed in case more pictures need to be taken. Risks There is always a slight risk of damage to cells or tissue from being exposed to any radiation. you will lie on an X-ray table. a doctor can see the results of a spinal X-ray in a few minutes. and how they are lined up. or foreign objects are present. Abnormal: Broken bones. You will be given a cloth or paper gown to use during the test. Usually 3 to 5 X-ray pictures are taken. X-ray pictures may be taken and aphysical exam done to see whether the brace can be taken off without hurting the spine. size. The soft tissues around the vertebrae look normal. In some clinics and hospitals. But the risk of damage from the X-rays is usually very low compared with the potential benefits of the test. You will need to remove any jewelry that may be in the way of the X-ray picture. especially if you have an injury. and the room may be cool. The spine is not abnormally curved.A spinal X-ray is taken by a radiology technologist. Otherwise. How It Feels You will feel no discomfort from the X-rays. depending on which area is examined. For example. dislocations. If the X-ray is being taken because of a possibly serious injury to your neck or back. Diseases that affect the spine. such as thin bones (osteoporosis) orarthritis. including the low levels of radiation used for this test. The X-ray table may feel hard. to prevent causing more injury a radiologist will look at the first X-ray pictures before taking others. such as from scoliosis. The X-ray pictures are usually read by a doctor who specializes in reading X-rays (radiologist). You need to lie very still to avoid blurring the pictures. X-ray pictures can be shown right away on a computer screen. a radiologist usually has the official X-ray report ready the next day. are present. Spinal X-ray Normal: The bones of the spine (vertebrae) are normal in number. No broken bones. or foreign objects are present. One or more bones in the spine may be abnormal because of a condition you were born with or because . The spine is abnormally curved. appearance. shape. You may find that the positions you need to hold are uncomfortable or painful. the radiation exposure from a chest X-ray is about equal to the natural radiation exposure received during a round-trip airline flight from Boston to Los Angeles (or Montreal to Vancouver) or 10 days in the Rocky Mountains (Denver. Colorado). dislocations. If you have a neck brace (cervical collar) in place. A spinal X-ray usually takes about 15 minutes. You may be allowed to keep on your underwear if it does not get in the way of the test. You may need to take off some of your clothes. Results In an emergency. During the X-ray test.

. Dunning MB III. Manual of Laboratory and Diagnostic Tests. discs. nerves. For more information. Sacral. an MRI. and organs on film. Fischbach FT. Thoracic. Barium shows up on X-ray films and can make it hard to get a clear picture. Spinal X-rays have been used by some employers to screen healthy people for possible future back problems. The most common causes of low back pain. do not show up on a spinal X-ray. If a potential employer wants you to have a spinal X-ray before you can start working. This can make it hard to see the details of the spinal X-ray. or a myelogram. If you are very overweight. Disc disease. 8th ed. such as a CT scan. (2009). The pictures may not be clear. Laboratory Tests and Diagnostic Procedures. Philadelphia: Lippincott Williams and Wilkins. Neck. Standard X-rays are performed for many reasons. eds. including diagnosing tumors or bone injuries. St. andMyelogram. which is fairly common. If you can't remain still during the test. infection. can sometimes be seen on a spinal X-ray as a narrowed space between the bones of the spine. or trauma. What To Think About     Sometimes your X-ray results may be different because you were tested at a different medical center or because earlier test results are not available to compare to the new test findings. But most health professionals do not believe that this is appropriate. Bone spurs can also be seen. Magnetic Resonance Imaging (MRI) of the Spine. you may want first to discuss the matter with the employer and your doctor. and ligaments than a spinal X-ray.ofcancer. Louis: Saunders. Lumbar. Other Works Consulted   Chernecky CC. provide more information about the spinal bones. see the topics Computed Tomography (CT) Scan of the Spine. If you have had a test with barium contrast material in the past 4 days. Other tests. neck. 5th ed. or Coccygeal X-ray Studies) Procedure overview What are X-rays of the spine. muscles. Berger BJ (2008). such as strained back muscles or ligaments. X-rays of the Spine. or Back (Cervical. bones. or back? X-rays use invisible electromagnetic energy beams to produce images of internal tissues. What Affects the Test Reasons you may not be able to have the test or why the results may not be helpful include:     If you are pregnant. The X-rays may not be safe for the fetus. joints.

or bone scans. is located in the vertebral canal and reaches from the base of the skull to the upper part of the lower back. The soft tissues in the body (such as blood. The thoracic area consists of 12 vertebrae in the chest area. X-rays may also be made by using computers and digital media. Images are produced in degrees of light and dark. Other related procedures that may be used to diagnose spine. the x-ray beam passes through the broken area and appears as a dark line in the white bone. The lumbar area consists of five vertebrae in the lower back area. a major part of the central nervous system. fused vertebrae. lumbar. A bone or a tumor. its organs. back. magnetic resonance imaging (MRI). thoracic. X-rays pass through body tissues onto specially-treated plates (similar to camera film) and a "negative" type picture is made (the more solid a structure is. When the body undergoes X-rays. At a break in a bone. or neck problems include myelography (myelogram). The sacrum has five small. X-rays of the spine may be performed to evaluate any area of the spine (cervical. computed tomography (CT scan). and other internal structures for diagnostic purposes.X-rays are made by using external radiation to produce images of the body. which is denser than the soft tissues. Please see these procedures for additional information. fat. The spinal cord. The four coccygeal vertebrae fuse to form one bone. depending on the amount of x-rays that penetrate the tissues. The spinal cord is surrounded by the bones of the spine and a . Click Image to Enlarge Anatomy of the spine The spinal column is made up of 33 vertebrae that are separated by spongy disks and classified into distinct areas:      The cervical area consists of seven vertebrae in the neck. Instead of film. different parts of the body allow varying amounts of the x-ray beams to pass through. and muscle) allow most of the X-ray to pass through and appear dark gray on the film. skin. allows few of the X-rays to pass through and appears white on the X-ray. the whiter it appears on the film). sacral. called the coccyx or tailbone. or coccygeal).

The spinal cord carries sense and movement signals to and from the brain and controls many reflexes. There may be other risks depending on your specific medical condition. If it is necessary for you to have a spinal X-ray. or other metal objects that may interfere with the procedure. neck. or back may be performed to diagnose back or neck pain. neck.sac containing cerebrospinal fluid. is required. Risks associated with radiation exposure may be related to the cumulative number of x-ray examinations and/or treatments over a long period of time. eyeglasses. tumors. Procedures may vary depending on your condition and your physician's practices. neck. degeneration of the disks. Reasons for the procedure X-rays of the spine. no prior preparation. spondylolisthesis (the dislocation or slipping of one vertebrae over the one below it). Before the procedure  Your physician will explain the procedure to you and offer you the opportunity to ask questions that you might have about the procedure. hearing aids. so that you can inform your physician. Risks of the procedure You may want to ask your physician about the amount of radiation used during the procedure and the risks related to your particular situation. Notify the radiologic technologist if you have had a recent barium x-ray procedure. your physician may request other specific preparation. If you are pregnant or suspect that you may be pregnant. jewelry.     During the procedure An X-ray may be performed on an outpatient basis or as part of your stay in a hospital. special precautions will be made to minimize the radiation exposure to the fetus. Generally. fractures or broken bones. an x-ray procedure of the spine. abnormalities in the alignment of the spine such as kyphosis or scoliosis. as this may interfere with obtaining an optimal x-ray exposure of the lower back area. Be sure to discuss any concerns with your physician prior to the procedure. such as fasting or sedation. or back follows this process:  You will be asked to remove any clothing. Based on your medical condition. arthritis. or back. Notify the radiologic technologist if you are pregnant or suspect you may be pregnant. . Generally. There may be other reasons for your physician to recommend an X-ray of the spine. you should notify your physician. It is a good idea to keep a record of your past history of radiation exposure. such as previous scans and other types of X-rays. or congenital abnormalities. Radiation exposure during pregnancy may lead to birth defects. hairpins.

  If you are asked to remove any clothing. It is extremely important to remain completely still while the exposure is made. The radiologic technologist will step behind a protective window while the image is taken. as any movement may distort the image and even require another study to be done to obtain a clear image of the body part in question. After the procedure Generally. you will be given a gown to wear. For example. the manipulation of the body part being examined may cause some discomfort or pain. Body parts not being imaged may be covered with a lead apron (shield) to avoid exposure to the X-rays. The radiologic technologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain.       Lumbar X-ray While the x-ray procedure itself causes no pain. your physician may give you additional or alternate instructions after the procedure. Some spinal x-ray studies may require several different positions. depending on your particular situation. Your physician may also request x-ray views to be taken from a standing position. back. particularly in the case of a recent injury or invasive procedure such as surgery. special care will be taken to prevent further injury. The x-ray beam will be focused on the area to be photographed. You will be positioned on an x-ray table that carefully places the part of the spine that is to be X-rayed between the x-ray machine and a cassette containing the x-ray film or digital media. a neck brace may be applied if a cervical spine fracture is suspected. The radiologic technologist will ask you to hold still in a certain position for a few moments while the x-ray exposure is made. there is no special type of care following an X-ray of the spine. or neck. However. If the X-ray is being performed to determine an injury. Online Resources .

The content provided here is for informational purposes only. We hope you find these sites helpful. or replace the professional medical advice you receive from your physician. This page contains links to other websites with information about this procedure and related health conditions. and was not designed to diagnose or treat a health problem or disease.NIH Scoliosis Research Society . American Academy of Orthopaedic Surgeons American Cancer Society Arthritis Foundation National Cancer Institute (NCI) National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institute of Child Health and Human Development National Institutes of Health (NIH) National Institute of Neurological Disorders and Stroke National Library of Medicine Osteoporosis and Related Bone Diseases . Please consult your physician with any questions or concerns you may have regarding your condition. but please remember we do not control or endorse the information presented on these websites. nor do these sites endorse the information contained here.National Resource Center .