Spinal Tests and Diagnosis Animation

Your spine specialist may order or perform spinal tests to further evaluate your neck or back symptoms and confirm your diagnosis. Some tests are part of your physical and neurological examination—such as assessing your range of motion (eg, how far can you bend to the side) and testing your reflexes.

The types of tests discussed in this short animation are those that provide your orthopaedic spine surgeon, neurosurgeon, pain management specialist, or other spine doctor a glimpse into your spinal condition beneath the skin’s surface.
Doctor reviewing a patient x-ray.An x-ray may help your physician see a spinal fracture, spondylolisthesis, infection or tumor. Photo Source: Pixabay.X-rays are the most common type of imaging physicians use to rule out a spinal disorder and/or confirm their diagnosis.  Radioactive materials are used to produce the x-ray. An x-ray may help your physician see a spinal fracture, spondylolisthesis, infection or tumor. He or she can also use x-rays to look at your spine from different angles: front, back, and side.  The densest parts of the spine’s anatomy images best, such as the vertebral bodies (bone).

CAT scans (Computer Assisted Tomography) or CT scans, as this test is often called, show bones and soft tissues. The images are far more detailed than x-ray and appear as slices of the anatomy.  Each slice is like a cross-section of the spine.  The CT machine is very capable and can rotate 180° around the patient’s body.  CT imaging can be combined with other tests, such as myelography (see below).  

MRI (Magnetic Resonance Imaging) produces images in more detail than CT scanning. MRI does not utilize radiation. Rather, powerful magnets and radio waves combined with sophisticated computer technology capture and render each anatomic picture. Like CT scans, MRI studies are presented as a series by anatomic plane.

Myelography produces images of the spinal cord and nerve roots called a myelogram. A contrast dye is injected, followed by x-ray, CT scan, or MRI imaging. The contrast dye illuminates the spinal canal and helps reveal areas of cord or nerve compression.

Discography involves injecting a contrast dye into intervertebral discs to pinpoint the cause of back and leg pain. This test is performed under fluoroscopy (real-time x-ray). Fluoroscopy is used to guide the needle into its precise target—the center of a disc. Pressure inside the disc increases as the contrast is injected. The purpose of the test is to replicate pain and other symptoms during the test. The results of discography are helpful in surgical planning (if spine surgery is recommended).

Bone scan is performed to detect, evaluate, and monitor diseases affecting bones and joints. Before the test, an intravenous line is started, and a radioactive tracer is injected. The tracer travels through the bloodstream and collects and attaches to bones and joints undergoing abnormal change. After the tracer has been given time to work, a special camera takes pictures. Dark spots on the bone scan images reveal potential problem areas.

EMG (electromyography) and NCS (nerve conduction study) are usually performed during the same appointment. EMG measures the electrical activity of a muscle (or group of muscles) at rest and when stimulated. NCS measures how quickly a nerve conducts a signal from one point to another. Both tests help determine if nerve injury or damage is present.

Facet joint blocks and other types of spinal injections are performed to reduce pain, but may also offer diagnostic significance. A facet joint block involves injecting a corticosteroid (a powerful anti-inflammatory) into the joint. The medicine works to reduce inflammation causing compression and irritation of the joint’s nerve. If the block reduces the patient’s pain, then the spinal pain generator is identified, and further treatment as necessary is provided.

Laboratory tests may involve collecting blood or other fluids. A spinal tap, also termed a lumbar puncture, is performed to obtain a sample of cerebrospinal fluid (which surrounds the spinal cord and brain).

If your spine specialist orders any of these tests, he or she will explain why the test results may benefit you and the potential risks involved. Remember, your physician is your best resource for information about your health. Your doctor and his or her staff are available to help you make well-informed decisions about your spinal condition, diagnosis, and treatment.

Updated on: 01/17/19
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