There are a number of diagnostic examinations that are used to determine the treatment that may be appropriate. These include the following:
The most common known diagnostic exam is an x-ray. An x-ray is a painless, non invasive imaging process that utilizes photographic film to absorb electromagnetic radiation transmitted through a material body. These images, which are sometimes termed radiographs, are used to diagnose and monitor treatment. Flexion and extension x-rays are used to pinpoint potential back instability.
CAT / CT SCAN
a CAT (computed axial tomography) scan (also termed a CT scan or computed tomography) is a painless imaging technique that utilises a computer to produce detailed three dimensional images of a body. The image is produced from a collation of cross sectional x-rays taken along an axis. A CAT scan is currently best able to produce images of bone and metal devices.
MRI (Magnetic Resonance Imaging)
This is a non invasive technique for imaging the spine that involves rotating a magnet around the body and exciting its hydrogen atoms. A scanner then detects the energy emitted by the excited atoms. As a human body is composed primarily of water, an MRI provides exceptional detail and is the single most useful test available for diagnosing spinal disorders.
A myelogram involves injecting a radiographic contrast dye into the dura (sac) surrounding the spinal cord and nerves, and then taking x-rays of the spine, enabling the nerve roots to be specifically x-rayed. Any abnormalities within the spinal canal such as nerve compression or a disc rupture can potentially be identified.
A discogram can determine whether a spinal disc is the cause of back or radicular pain. Using a fluoroscope for guidance, the doctor inserts a spinal needle into the disc and injects radiopaque dye into the centre (nucleus) of the disc,. In a healthy disc the dye will remain contained within the central nucleus. If the dye leaks out of the nucleus into the surrounding tissue the disc is considered abnormal if concordant symptoms during the injections replicate the complaints usually noticed by the patient.
A bone scan involves intravenously injecting a small quantity of a radiographic marker into the patient and then scanning the area of concern. The scanner detects the marker, which concentrates in any region exhibiting high bone turnover. A bone scan is utilised when there is suspicion of infection, small fractures, or a tumour ie conditions that all result in high bone turnover.
A DEXA (Dual Energy Absorptiometry)( scan measures bone mineral density to check for possible bone loss. The patient lies on a padded table whilst the DEXA scanner beams x-rays from two sources towards the bone being examined - usually the lower spine or hip. A radiation device is passed slowly over the examination area producing images that are projected onto a monitor. A computer then
analyses the images and calculates the bone density based on the amount of radiation absorbed by the bone. The denser the bone the more radiation it absorbs.