What does the photo show?
If you have been prescribed an X-ray of the lumbar spine, you should familiarize yourself with what the result of such a study will show. The doctor will have information regarding:
- developmental anomalies and pathologies - additional vertebrae, irregular shape of their bodies or processes;
- violations of the integrity of bones - fractures, displacements, cracks, dislocations, etc.;
- osteochondrosis – the joint space decreases, degenerative processes occur in the end plates;
- spondylosis – areas of ossification;
- spondyloarthrosis – the joint space narrows, bone tissue grows;
- hernia - the presence of protrusions of the spinal cord, however, it is difficult to determine such a disease on X-rays; it can only be judged by indirect signs; MRI
; - tuberculous spondylitis - the vertebral fissure narrows, osteoporosis of the affected vertebrae is noted, cavities and destruction occur, a wedge-shaped curvature of the vertebral body may occur;
- tumors.
What is a spinal x-ray?
The X-ray method is based on the ability of human body tissues to transmit X-rays to varying degrees. They are fixed on a special film, which is placed behind the patient’s body.
The source of radiation is an X-ray tube placed in front. Bone structures have less capacity for rays. For this reason, their photograph appears whitish on film.
Structure of a fluoroscope and x-ray tube
At the same time, prints of soft tissues and organs that contain air (lungs, intestines) appear darker on film. An X-ray image is a negative image in which light elements are called darkening, and dark areas are called clearing.
X-rays usually do not show intervertebral discs . Diagnosis is carried out by the size of the gaps between the vertebrae, their shape and the nature of the displacement. X-rays make it possible to determine the position of vertebral fragments and the presence of cracks or fractures in them.
This method also allows you to see the curvature of the spinal column in different planes. X-rays are taken in different positions of the body to determine the compensatory capabilities of the discs.
The image allows you to see the following diseases:
- osteochondrosis;
- different types of tumors;
- presence of inflammation;
- the beginning of the development of diseases in the spine;
- congenital anomalies;
- condition of bone tissue;
- accumulation of liquids;
- thinning of bone tissue;
- intervertebral hernia;
- vertebral displacements.
Video: “How does X-ray work?”
Advantages of a back x-ray over other diagnostic methods
The X-ray method has a number of advantages, including:
- availability;
- cheapness;
- ease of diagnosis;
- high level of information content when assessing the condition of bones and tissues;
- the ability to get results quickly enough;
- painlessness.
Until recently, diagnostics using X-rays was dangerous due to the high dose of radioactive radiation. Modern devices used in medical institutions have significantly lower levels of radiation exposure. In addition, the level of exposure can be adjusted depending on the tasks assigned and the organs being examined. .
Is it harmful to have a CT scan of the spine?
Computed tomography involves exposing the patient's body to x-rays. The radiation load from MSCT is insignificant. Sanitary and hygienic standards have been developed, compliance with which ensures the safety of the health of the examinee.
The permissible radiation exposure per year does not exceed 5 mSv (millisieverts). On average, 2 CT scans of the spine are allowed within 12 months.
The child's body reacts more acutely to the effects of ionizing radiation. The age limit for prescribing native CT is 5 years. Intravenous injections of a contrast agent to a child are provided in a hospital setting. From the age of 12, restrictions are lifted; computed tomography can be performed in specialized centers in compliance with safety measures.
Absolute contraindications to CT scan of the spine:
- pregnancy - ionizing currents have a teratogenic effect on the fetus;
- radiation sickness and other pathologies that exclude the possibility of using x-rays.
When using contrast, the list of restrictions expands:
- iodine intolerance - allergic reactions are possible;
- hyperfunction of the thyroid gland - contrast injection leads to increased symptoms of thyrotoxicosis;
- renal failure - when removing the “coloring” solution, the load on the filtration organs increases;
- diabetes mellitus during treatment with Metformin - simultaneous use of an iodine-containing drug with the named drug increases the concentration of lactic acid in tissues.
Fracture (shown by arrow) of the vertebral body
In the absence of contraindications, MSCT does not have a negative effect on the patient’s body.
What does radiography of the lumbar spine with functional tests mean?
X-rays with functional tests are taken in a lateral projection at the points of flexion of the spine. In some cases, an X-ray examination of the spine with functional tests is performed, which is a picture in a lateral projection .
It is performed at the points of flexion and extension of the spinal column in maximum positions .
To do this, choose a vertical or sitting body position, which allows you to get the most informative picture.
Performing such a procedure may have limitations due to the patient’s condition, as well as depending on the brand of device used.
Depending on the objectives of the examination, this method can be used in different body positions:
- Lying down . In this case, for bending, the patient lies on his side, placing his head on the bent arm, and bending his legs and pulling them towards the stomach. For the extension pose, the patient stands sideways on a vertical base, bending one arm and placing it behind the head. The second hand holds the edge of the table.
- Sitting . To take a flexion photograph, the patient sits sideways against a vertical base, touching it with his torso; arms should be crossed, they should be clasped around the knees, resting the elbows on the hips; The torso should be tilted forward as much as possible. For the extension pose, the patient must bend back to the maximum amplitude, throw back the head and arch the chest.
- Standing _ For flexion, the patient is placed standing sideways at a vertical base, which must be touched with the body; Bend forward as far as possible, touching your hands to the floor and keeping your knees straight. Extension is performed from a standing position at a vertical base, while bending back and throwing back the head; hands should be clasped at the back of the head.
Video: “Modern diagnostic methods”
Algorithm for X-ray diagnostics
X-rays of the lumbar region can be performed in three projections: oblique, lateral and straight. Images can be taken in a standing or lying position, everything directly depends on the patient’s well-being and the complexity of the diagnosed disease. Most often, the procedure is performed lying down for curvature of the spine. In order to determine the mobility of the department, so-called functional tests are carried out: a series of photographs are taken in different projections with tilts to the right, left, forward and backward.
It is important to protect the reproductive organs from X-ray radiation during the examination. For this purpose, special radiation-resistant plates are used. But their use is not always possible; for example, during the period of examination of the sacrococcygeal region, the plates will simply cover the desired area. It is recommended to discuss all these points with your doctor, and, perhaps, choose a diagnostic method that is safer for the body.
For what diseases are x-rays taken of the lumbosacral spine?
An X-ray of the lumbosacral spine is performed if the following indications are present::
- for traumatic injuries;
- presence of spinal column deformities;
Often, x-rays of the lumbosacral region are done to diagnose injuries and bruises, pain in the lumbar and sacral area;- with existing signs of numbness;
- in case of paresthesia of the lower extremities;
- with leg muscle cramps;
- primary or secondary (metastatic) malignant processes in the bone tissues of the spine;
- benign neoplasms of the vertebrae;
- there are suspicions of rheumatological pathologies that can cause damage to the spine (ankylosing spondylitis);
- infectious lesions of the spine (tuberculosis, syphilis, osteomyelitis);
- diagnostics before and after surgery;
- monitoring the dynamics of diseases during therapy;
- for congenital pathologies of the spine.
A referral for an examination can be given by a therapist, neurologist, orthopedist-traumatologist or vertebrologist. The direction should indicate the area of the spine that should be studied using the projection method.
Find out what other methods are used to examine the spine:
- You can learn more about MRI of the cervical spine on the page
- How is an MRI of the thoracic spine done?
- Follow this link to find out how and when a thoracic x-ray is done.
- To find out why a CT scan of the spine is done, go here
Contraindications and indications
X-rays will be required in certain cases. Mainly:
- presence of pain in the back area;
- curvature of posture;
- injuries of various origins;
- pain in the buttocks or thighs;
- numbness of the limbs;
- suspicion of a number of diseases - intervertebral hernia, arthritis, osteochondrosis, etc.
Radicular syndrome in cervical osteochondrosis
Attention! Since radiography is not able to accurately show the condition of the soft tissues of the body, from the point of view of the reliability and accuracy of the results, when examining the spine for the presence of hernias and similar diseases, it is recommended to conduct an MRI. The method is more expensive, but in this case more effective.
X-ray diagnosis of the patient
In some cases, x-rays cannot be used as a research method. For example, contraindications, although not absolute in most cases, are:
- the first months of pregnancy, and the entire pregnancy in general . X-rays can have a negative impact on the developing fetus and can cause negative and irreversible changes in the body of the unborn child;
- small age . It is not recommended for very young children to do such a study. Either radiography in this case is important to carry out with a number of precautions and only if there are serious indications;
- the patient's inability to remain motionless for a short time . In this case, the picture will be blurry and uninformative;
- inadequate condition of the subject.
Because a child's spine is flexible, serious injuries in children are rare.
On a note! Significant excess weight will not give reliable results. X-rays will be ineffective.
Contraindications to X-rays
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Next fact
Despite the fact that x-rays are used quite often, in some cases this procedure may be contraindicated.
First of all, x-rays pose a great danger to:
- women during pregnancy and breastfeeding;
- small children;
- people who are overweight;
- patients in serious condition;
- persons suffering from nervous disorders.
If an X-ray is urgently needed while a woman is pregnant, then during the examination a special protective screen is used to cover the abdomen. In the future, all consultations with a gynecologist should be carried out much more carefully. The procedure poses the greatest danger during the first trimester due to the formation of all organs and systems in the fetus during this period .
By decision of the World Health Organization, the use of x-rays for children under 15 years of age is prohibited. If a procedure is necessary, the child must be covered with a protective oilcloth.
How to prepare for and attend an x-ray?
Step 1. You need to visit a doctor and take a referral for an X-ray examination of the spine.
Take a direction first
Step 2. If it is necessary to examine the lumbosacral region, it is important to adhere to the above-described diet for 2 days before the x-ray.
Follow a special diet
Step 3. You need to do a colon cleanse. If other parts of the spine are to be examined, then steps 2 and 3 can be neglected.
Cleanse your colon
Step 4: It is recommended to wear comfortable clothing that can be easily taken off and put on.
Wear comfortable clothes
Prices for orthopedic shoes
Step 5. At the appointed time, you need to come to the clinic, not forgetting the directions, and wait for the doctor to be invited to the office.
Visit a doctor
Step 6. In the office, it is important to do everything that the specialist says - undress, take off your jewelry, take the desired position.
Preparing for an X-ray
In order for the result of an X-ray examination to be the most informative and for the image to be of high quality, careful preparation is required, which does not present much difficulty.
The biggest obstacle to examination is the accumulation of stool and gas bubbles. The main stages of the preparatory procedures must be explained by a specialist.
Preparing for an x-ray consists of the following steps::
- Three days before the proposed examination, foods that contribute to the formation of gases should be excluded from the menu, such as fermented milk products, peas, beans, fresh vegetables and fruits, sauerkraut, soda.
Familiarize yourself with the stages of preparation for an x-ray of the lumbar region. It is recommended to eat food in liquid form, including tea and broths.- Before each meal you need to drink two tablets of enzyme preparations, such as Mezim, Pancreatin. After finishing your meal, you need to drink activated charcoal.
- In order for the patient to feel comfortable during the examination, it is worth drinking an infusion of valerian three times a day, 10 drops.
- The last meal on the day before the examination should not be later than 18.00 in the evening, which will ensure the clarity of the image.
- The night before and on the day of the x-ray, you will need a cleansing enema or a laxative (Fortrans). You can also drink warm salted water.
- Immediately before the examination, eating or drinking water is prohibited.
How is the X-ray procedure performed?
Before the x-ray, the patient must remove all metal objects.
The procedure goes as follows:
- The patient lies down or sits on a prepared table. In order to protect organs located near the spine from harmful radiation, the specialist applies shielding material.
- During the diagnosis, the doctor must go into the next room, which will minimize the radiation received. The doctor measures the amount of radiation received using a personal dosimeter.
- X-rays of the sacrolumbar spine are performed in two projections: direct posterior and lateral. In some cases, an oblique projection can be made.
- When taking an image, the patient must remain motionless and clearly do everything that the doctor requires over the speakerphone.