Spine examination is one of the most frequently ordered examinations, and this is because back pain is one of the most common ailments complained of by people of almost all ages. But it is worth remembering that not all pain in the area of ​​the spine is directly related to it.

Spine examinationallows you to find the cause of the pain. If you go to the doctor because of back pain and you suspect that it may be related to the spine, it should be carefully described under what circumstances the pain occurs, whether it is severe, or it subsides after rest, exercise or taking a painkiller.

Each piece of information can be important for the correct diagnosis, but also for selecting the right type of imaging test. The right one, that is, one that will finally explain the cause of the ailments. For each imaging examination (even for the so-called ordinary x-rays), we must have a referral from a doctor.

The first spine examination will be performed by the doctor in the office. He will examine and palpate the spine, which will allow to recognize, for example, curvatures or other abnormalities in its structure.

Spine examination - X-ray

X-ray examination (photo, X-ray) of the spine is an examination that starts the diagnosis of the spine. They are performed in special rooms with appropriate precautions. Before the examination, undress to the waist and remove any ornaments from the neck. Then we stand in front of the camera screen and the technician takes the picture. As suggested by the doctor, the examination can also be performed in a side position. The examination is painless and safe.

The photos clearly show all degenerative changes, curvatures of the spine, changes in the structure of the vertebrae, etc. The test result can be picked up after a few days. Usually, the photos are placed on a disc, which is also accompanied by a description of the photos made by the radiologist.

Spine examination - computed tomography

A tomographic examination (CT or CT) is the simplest and most frequently used imaging diagnostic method, which allows to assess the layered sections of organs. In about 50% of people it allows to make a correct and final diagnosis, in 30%. cases is of auxiliary importance, in 20% of patients it completes the diagnosis process.

Computed tomography is the basic method used in the diagnosis of the brain andof the lumbosacral spine, especially in the case of suspicion of a hernia of the nucleus pulposus, i.e. a popular discopathy. Thanks to the CT of the spine, it is possible to locate the focus of the disease, even a few millimeters in diameter, and the images of the organs can be presented with great accuracy, because the obtained image allows for the layered examination of the tissues.

There is no need to prepare yourself for the examination with the use of a CT scanner. Only before the contrast test, it is necessary to refrain from eating for 6-8 hours. The test is painless and takes 10 to 30 minutes.

During the examination, you lie in a special tunnel made of the table and the housing of the tomograph itself. You must not move during the examination. People who suffer from claustrophobia (fear of closed rooms), overactive patients and young children are given sleeping pills before the examination. The dose of rays the patient receives during the examination is slightly higher than in a traditional X-ray, but the examination provides much more information than a simple X-ray.

A physical phenomenon used in computed tomography is X-rays passing through the body on its path. The resulting image is recorded by a special device. It is a two-dimensional projection of the observed object, i.e. a fragment of our body.

As in every digital technique, in computed tomography it is possible to enlarge and divide the image as well as to reconstruct it. However, these possibilities depend on the camera software. When x-raying the organs, a computer tomograph takes cross-sectional photos every 2-10 mm. The thickness of the tested layers depends on the indications resulting from the pathology sought.

Spine examination - MRI

Magnetic resonance imaging (MRI) is a very accurate method of representing organ cross-sections. In Poland, the first magnetic resonance imaging machines started working in 1991.

MRI does not use X-rays, but the phenomenon of nuclear magnetic resonance. For good signal reception from the human body, the MRI system must be isolated from all external electromagnetic waves. That is why the MRI machine is placed in a special room, the so-called Faraday's cage.

The test consists in placing the patient in the chamber of the apparatus, in a constant high-energy magnetic field. This causes the lines of the magnetic field generated by the nuclei of atoms that make up the human body to line up parallel to the direction of the generated magnetic field. This is how the arrangement of atoms as it isman, is orderly and stabilized.

Additionally, the device emits (through special coils) electromagnetic waves similar to radio frequency (RF), which, reaching the patient and his individual tissues, induce the formation of similar radio waves in these tissues (this phenomenon is called resonance). The electromagnetic waves generated by the tissues are in turn picked up by the device's antenna around the patient.

In practice, the nucleus of a hydrogen atom is used as the "resonator". The number of hydrogen nuclei in individual tissues varies, which, among other things, allows for the formation of an image. In other words, a map of the distribution of hydrogen atomic nuclei in the human body is created. By making complex calculations, the computer presents the obtained data on the screen in the form of images of the anatomical structures of the patient's body.

Patients are sometimes given a contrast agent (contrast) prior to testing to improve image quality and make the diagnosis more reliable. MRI contrasts are so safe that they can even be used in patients with an allergic reaction to X-ray contrast. MRI contrast media do not interact with other medications and are excreted unchanged, mainly by the kidneys.

Indications for an MRI examination of the spine

With the help of resonance, very good images of the spine and the surrounding spaces are obtained. Magnetic resonance imaging in the case of spinal diseases is performed when it is necessary to diagnose, for example, tumors of the spinal canal (spinal cord) or to assess the structures of the spinal canal.

Before the test, you do not need to follow any diet, use laxatives, or be on an empty stomach. You can eat meals before the test, even if a contrast agent is administered intravenously during the test.

If the patient is taking any medications, most likely he will be able to take them before and after the test.

There is no need to take off your clothes, but metal items such as earrings, brooches, necklaces, watches, as well as pens, keys and more should be removed. Must be dressed in a suit that does not contain metal zippers and the same fasteners. Patients should also remove all removable dentures and notify their physician if they have other metal implants or foreign bodies.

An implanted pacemaker is an absolute contraindication to the examination. A relative contraindication to the MRI examination is the presence of:

  • contraceptive IUD (if metal)
  • artificial heart valve
  • vascular prostheses ("stent"),
  • vascular clips
  • metallic orthopedic implants: artificial joints, wires, screws and stabilizers

Pregnant women should inform their doctor about it. On the day of the examination, ladies should give up make-up, as some cosmetics may contain particles of non-ferrous metals.

The test takes 10 to 30 minutes. During the examination, the patient lies in the center of the MRI scanner tunnel (it is neither dangerous nor painful). To increase the comfort of testing, additional lighting and ventilation are installed inside the tunnel. The patient is in constant contact with the staff.

Each MRI sequence takes 3 to 10 minutes. During this time, the patient hears a sound resembling the spinning of a washing machine. The noise lasts from a few to several minutes, then fades away, and reappears after some time. It is related to the correct operation of the device and should not cause anxiety.

If several images are required, the table will automatically move to the appropriate position. The patient should then continue to remain still as long as possible.

Depending on the type of examination, the complete procedure may take from 30 to 90 minutes.

About the authorAnna Jarosz A journalist who has been involved in popularizing he alth education for over 40 years. Winner of many competitions for journalists dealing with medicine and he alth. She received, among others The "Golden OTIS" Trust Award in the "Media and He alth" category, St. Kamil awarded on the occasion of the World Day of the Sick, twice the "Crystal Pen" in the national competition for journalists promoting he alth, and many awards and distinctions in competitions for the "Medical Journalist of the Year" organized by the Polish Association of Journalists for He alth.

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