Standard MRI protocols for spine imaging include axial, sagittal and coronal images. Spinal diseases which may be not be detected with x-rays or CT may be detected with MRI. Utilizing different pulse sequences to create contrast between the tissues, information about all the elements of the spinal column and its contents (spinal cord, nerve roots and cerebrospinal fluid) can be obtained. If a clinician needs additional information to direct therapeutic decisions, MRI, with its excellent soft tissue discrimination and multiplanar imaging capabilities, is the optimal imaging exam to evaluate the spine in most clinical situations. ![]() If malalignment or instability of the spine is of clinical concern, flexion/extension and/or lateral bending views may also be obtained with the patient standing or supine.įor accurate assessment of scoliosis, long 52" views of the entire spine are obtained. If requested by the referring physician, additional views of the spine are obtained, including oblique views to evaluate the spinal posterior elements and a lateral spot view of the lumbosacral junction. At HSS, we image the patient in the standing position, which provides an axial load on the spine, in order to optimize the assessment of spinal alignment. The standard conventional radiographic exam of the spine consists of 2 views of the spine: AP (frontal) and lateral, obtained with the patient supine (lying). It also uses ionizing radiation, which needs to be limited whenever possible. Conventional radiography, however, is primarily for the evaluation of the bony structures. Information about spinal alignment can be obtained under static and dynamic conditions. Conventional radiographs ( x-rays) provide an overview of the spine. Various Imaging Examinations/ModalitiesĬonventional radiography is often the first imaging examination utilized to evaluate patients with low back pain. Radiologists also perform image-guided spine interventions, such as facet blocks and epidural steroid injections. Multiple imaging examinations utilizing different equipment or modalities are available, including conventional radiographs (x-rays), magnetic resonance imaging (MRI), computerized tomography (CT), myelography and discography. The radiologist has a vital role in diagnosing the cause of back pain and guiding treatment. Some of the more common causes are disc herniation, degenerative disc disease, osteoarthritis, malalignment including scoliosis and spondylolisthesis, osteoporotic compression fractures, trauma, tumor, infection, seronegative spondyloarthropathies and sacroiliitis. Low back pain or what has commonly been referred to as "sciatica" or "lumbago" can have many etiologies and, often, is multifactorial. In fact, four out of every five Americans can expect to experience an episode of back pain at some time in their lives. It is estimated that the annual cost of low back pain in terms of lost production, medical expenses and workmen's compensation benefits is in the tens of billions of dollars. Low back pain is a leading cause of medical disability and lost work time in the United States. Special Techniques- Myelography and Discography. ![]() ![]()
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