Spinal Imaging Cervical Thoracic Lumbar Spine with MRI and CT by KBNI Houston
Spinal imaging tests of the cervical, thoracic, and lumbar spine are essential for correctly diagnosing spinal deformities, injuries, and other related problems. Physicians normally start with a patient history and a physical exam to test the patient’s mobility, range of motion, and look for points of tenderness. Based on the findings, physicians can then make recommendations for the best course of treatment. Minor injuries such as muscle pulls may be treated with pain relievers, anti inflammatory medications and rest, and core strengthening exercises. If the patient’s neck or back (cervical, thoracic or lumbar spine) pain is not mediated by these measures, however, then a physician may recommend a series of spinal imaging tests to determine whether the problem is structural. Spine imaging can consist of X ray,MRI or CT scans of the anatomy of the cervical, thoracic or lumbar spine.
X ray, CT scans and MRI scans of the cervical, thoracic and lumbar spine show the physician different information about the body. X ray of the spine shows alignment very well, as well as fractures of the vertebral bodies. They can show collapse of the disc spaces (disc degeneration), and slippage of the bones (vertebral bodies) upon each other, known as spondylolisthesis. X rays do not show herniated discs pushing into the spinal canal, unless the disc is calcified, in which case the calcium in the bone spur may show up on x ray. X ray is good for showing the placement of hardware for spinal fusion (such as pedicle screws in the lumbar spine, and anterior cervical plates in the cervical spine) in the spine. Bone growing between vertebral bodies and between transverse processes of a spinal fusion are also well seen on X ray and CT scans.
CT scans of the cervical, thoracic or lumbar spine anatomy show very detailed views of the cross sectional anatomy of the spine. The images are taken as cross sections of the body, and these thin slices of information can be processed by the imaging computer, and reconstructed to show the spine as seen in the sagittal plane (from the side) or coronal plane (as seen from the front). A CT scan of the cervical, thoracic or lumbar spine can show fractures very well. They also show the placement of screws into the spine, after surgery, very well. CT scans of the spine do not show great detail of the soft tissues of the spine, such as the nerve roots passing through the spine, of the spinal cord running through the spine. If a CT scan of the spine is performed after the patient undergoes a myelogram, the spinal nerves and spinal cord can be better visualized. A myelogram is performed when a radiologist performs a spinal tap on a patient, by placing a spinal needle into the lumbar spine. Even though this sounds like a difficult procedure, it is generally accompanied with minimal pain. After the needle is in the spinal sac, or dural sac, the next step is to place a dye (which can be seen on CT scan) or contrast agent within the thecal sac. Once this is completed, a CT scan is done through the appropriate portions of the spine (cervical, thoracic or lumbar), and the contrast dye shows up as white on the CT scan, while the nerve roots or spinal cord show up as dark shadows against the bright spinal fluid. The myelogram procedure can accurately show disc herniations into the nerve roots or spinal cord.
MRI scan of the cervical, thoracic or lumbar spine shows soft tissue, such as disc bulges (which may cause sciatica), spinal stenosis, spinal cord and nerve roots, very well. It can also be used to see areas of contusion within the spinal cord. It shows images in the axial plane (cross sections through the spine or body), as well as the coronal and sagittal planes.
Magnetic resonance imaging (MRI), for example, is often used when the physician suspects damage to the soft tissues around the spinal cord. The spinal cord runs most of the length of the spinal column and houses the central nervous system’s spinal nerves, which are responsible for transmitting sensory information to the brain in addition to signals for voluntary muscle control. Physicians can use magnetic resonance imaging to see if these nerves or other soft tissues have been damaged by spinal fracture, impact trauma, or otherwise compromised by spinal deformities. CT scans (computerized tomography) and X-rays do not produce detailed images of soft tissue, so physicians typically do not require them to analyze soft tissue damage in the spine—unless that damage is suspected to be the result of a damaged vertebra. Magnetic resonance imaging can also reveal spinal abscesses and spinal tumors before they have a chance to compress spinal nerves, which often causes extreme pain.
If spinal fracture is suspected, physicians may require CT scans and X-rays to determine the extent of the fracture’s damage, as well as a magnetic resonance imaging exam to ensure the integrity of the spinal cord. Patients may think that these tests are excessive given that many spinal fractures occur during everyday motion (such as picking up a bag of groceries), but physicians must be absolutely certain that the soft tissues of the spinal cord are not compromised. Spinal column integrity greatly reduces the chances of the spinal nerves becoming compressed by nearby vertebrae, though the spinal disks (shock-absorbing pads between the vertebrae) can still degenerate to the point where compressed spinal nerves are a significant problem. All of these imaging exams serve to ensure that patients make safe recoveries.
Summary of Uses of Various Spinal Imaging Modalities:
X Ray: useful for evaluating curvature of spine, such as scoliosis; fractures; spinal alignment; instrumentation placed in the spine (pedicle screws, rods, plates); fusion between adjacent vertebral levels
CT scan of cervical, thoracic or lumbar spine: useful for evaluating fractures of spine; alignment of spine; bone spurs in cervical thoracic and lumbar spine
CT with myelogram: useful for evaluating nerve roots in cervical, thoracic and lumbar spine; spinal stenosis; fusion between adjacent vertebral levels (often used instead of MRI if patient has a pacemaker or implanted spinal cord stimulator)
MRI scan of cervical, thoracic or lumbar spine: useful for evaluating herniated disc, spinal stenosis, spondylolisthesis
Physician experts at the Kraus Back and Neck Institute (KBNI) in Houston TX have significant experience at taking care of patients with back problems, back injuries and other sources of back and neck pain. They frequently see patients who are suffering from the symptom of neck pain, low back pain, and mid back pain, and have never received imaging studies of the spine. Physicians at the KBNI will order the appropriate spinal imaging studies of the cervical, thoracic or lumbar spine as needed, and review the results with the patient.
The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.
Patients suffering from neck pain or back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at
……. Or visit www.SpineHealth.com to schedule an appointment online
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