A Patient's Guide to X-rays of the Spine

What it is: An X-ray is a painless test that uses radioactive beam to take pictures of bone. The beam is shot through your body onto a special film, just like a camera.

What the test shows: X-rays are good at showing bone. X-rays will definitely be helpful if your doctor suspects a fracture of the spine, an infection, or a tumor. If your doctor suspects that your problem may be from degeneration of the spine, X-rays can be used to see if there is a decrease in the height of space between vertebrae, bone spurs, or facet hypertrophy. Sometimes X-rays are taken while you are in different positions. For example, X-rays may be taken while you bend forward and another while you straighten your spine. These X-rays can be compared to see if there is too much movement between vertebrae. This may help determine if there is segmental instability during flexion and extension of the spine. The test is called a flexion-extension view of the spine.

What the test does not show: X-rays of the spine do not show the soft tissues. This means that the test is not very good at showing nerves, discs, or ligaments. X-rays have been around for over 100 years, so doctors have used them to try and get as much information as possible about the soft tissues by looking at the way the bones line up and the way that certain shadows appear to be out of alignment. Today we have many tests that show the soft tissues much clearer, so doctors do not have to rely on X-rays to show these things.

How the test is done: During X-rays, you will be asked to lie very still on a table or stand very still and hold certain positions while pictures are taken of your spine. It is much like having your photograph taken and is over very quickly.

What risks the test has: X-rays use radiation, which in large doses can increase the risks of cancer. The vast majority of patients who get X-rays will never get enough radiation to worry about cancer. Only patients who must have multiple X-rays (hundreds) over many years need worry about this risk. Children and young adults who plan to have children should be protected from radiation exposure to the testicles and ovaries. The radiation may damage the sperm and eggs. It is simple to protect the area whenever possible by shielding it with a lead apron or blanket.

What the test costs: An X-ray of the spine usually has two costs associated with the test. The first cost is the fee for actually doing the test. This is called the "technical fee". The second cost is the fee of having a specialist, such as a radiologist, read and interpret the test. This is called the "professional fee". You may get two bills for this test: one from the hospital or clinic that took the X-ray, and one from the specialist who read the test.

Copyright © 2003 DePuy Acromed.

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